Healthcare Provider Details

I. General information

NPI: 1144514753
Provider Name (Legal Business Name): BENJAMIN STEVEN GOINS DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2011
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1495 HICKORY FLAT HWY STE 140
CANTON GA
30115-4267
US

IV. Provider business mailing address

1720 WINDWARD CONCOURSE
ALPHARETTA GA
30005-2291
US

V. Phone/Fax

Practice location:
  • Phone: 678-513-2273
  • Fax: 678-513-8869
Mailing address:
  • Phone: 678-513-2273
  • Fax: 678-513-8869

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number0102203480
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: