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1508870205 NPI number — CHARLES D. GOFF M.D.

NPI Number: 1508870205
Health Care Provider/Practitioner: CHARLES D. GOFF M.D.

Information about “1508870205” NPI (CHARLES D. GOFF M.D.) exists in 1508870205 in HTML format HTML  |  1508870205 in plain Text format TXT  |  1508870205 in PDF (Portable Document Format) PDF  |  1508870205 in an XML format XML  formats.

NPI Number : 1508870205 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1508870205",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "GOFF",
    "FirstName": "CHARLES",
    "MiddleName": "D.",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "M.D.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "PO BOX 388",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "FISHERSVILLE",
    "MailingAddressStateName": "VA",
    "MailingAddressPostalCode": "22939-0388",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "540-245-7705",
    "MailingAddressFaxNumber": "540-245-7710",
    "FirstLinePracticeLocationAddress": "70 MEDICAL CENTER CIR",
    "SecondLinePracticeLocationAddress": "SUITE 213",
    "PracticeLocationAddressCityName": "FISHERSVILLE",
    "PracticeLocationAddressStateName": "VA",
    "PracticeLocationAddressPostalCode": "22939",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "540-245-7705",
    "PracticeLocationAddressFaxNumber": "540-245-7710",
    "EnumerationDate": "07/28/2006",
    "LastUpdateDate": "11/10/2023",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "2086S0129X",
        "TaxonomyName": "Vascular Surgery Physician",
        "LicenseNumber": "0101056658",
        "LicenseNumberStateCode": "VA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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