Healthcare Provider Details

I. General information

NPI: 1811936610
Provider Name (Legal Business Name): JAMES N GOLDMAN DC
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1060 WILLIAM WAY NW
CLEVELAND TN
37312-4369
US

IV. Provider business mailing address

PO BOX 4640
CLEVELAND TN
37320-4640
US

V. Phone/Fax

Practice location:
  • Phone: 423-614-0884
  • Fax: 423-614-0882
Mailing address:
  • Phone: 423-614-0884
  • Fax: 423-614-0882

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC2053
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: