Basic Information
| Provider Information | |||||||||
| NPI: | 1982676292 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GOINS | ||||||||
| FirstName: | MAURICE | ||||||||
| MiddleName: | LAMONT | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6635 LAKE DRIVE | ||||||||
| Address2: | |||||||||
| City: | MORROW | ||||||||
| State: | GA | ||||||||
| PostalCode: | 30260 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7709681323 | ||||||||
| FaxNumber: | 7709684556 | ||||||||
| Practice Location | |||||||||
| Address1: | 1336 WEST HIGHWAY 54 | ||||||||
| Address2: | BLDG 500 | ||||||||
| City: | FAYETTEVILLE | ||||||||
| State: | GA | ||||||||
| PostalCode: | 30214 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7704611238 | ||||||||
| FaxNumber: | 7704606610 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/02/2006 | ||||||||
| LastUpdateDate: | 03/27/2008 | ||||||||
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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 | 207X00000X | 058745 | GA | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207XS0117X | 058745 | GA | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Orthopaedic Surgery of the Spine |
No ID Information.