Basic Information
| Provider Information | |||||||||
| NPI: | 1548458375 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GOINS | ||||||||
| FirstName: | CARL | ||||||||
| MiddleName: | DOUGLAS | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | III | ||||||||
| Credential: | PAC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1431 CENTERPOINT BLVD STE 100 | ||||||||
| Address2: | |||||||||
| City: | KNOXVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 379321983 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8659857012 | ||||||||
| FaxNumber: | 8659857077 | ||||||||
| Practice Location | |||||||||
| Address1: | 1431 CENTERPOINT BLVD STE 100 | ||||||||
| Address2: | |||||||||
| City: | KNOXVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 379321983 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8659857012 | ||||||||
| FaxNumber: | 8659857077 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/05/2007 | ||||||||
| LastUpdateDate: | 05/27/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | TN | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363AM0700X | 1546 | TN | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.