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General NPI Number Information
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NPI Number | 1033614458
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Entity Type | Individual
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Provider Name | ANDREW JAMES GOATES MD
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Gender | Male
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Dates
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Enumeration Date | 03/27/2018
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Last Update Date | 03/10/2025
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Provider Practice Location Address
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Address Line | 1350 N 500 E
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City | LOGAN
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State | UT
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Zip | 84341-2400
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Country | US
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Telephone | 435-752-1693
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Fax | 435-792-1692
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Provider Business Mailing Address
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Address Line | PO BOX 27128
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City | SALT LAKE CITY
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State | UT
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Zip | 84127-0128
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | MD214601
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 65850
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 29286
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License Number State | MN
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Taxonomy #4
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 7992818-1205
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License Number State | UT
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