Healthcare Provider Details

I. General information

NPI: 1003174350
Provider Name (Legal Business Name): ANDREW DAVID GOINS DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2012
Last Update Date: 09/10/2024
Certification Date: 09/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 FORT SANDERS WEST BLVD STE 301
KNOXVILLE TN
37922-3398
US

IV. Provider business mailing address

9330 PARK WEST BLVD STE 402
KNOXVILLE TN
37923-4308
US

V. Phone/Fax

Practice location:
  • Phone: 865-690-3003
  • Fax: 865-374-2143
Mailing address:
  • Phone: 865-690-3003
  • Fax: 865-690-6404

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberDO0000002737
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: