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General NPI Number Information
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NPI Number | 1548627284
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Entity Type | Individual
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Provider Name | CHRISTOPHER MCGOLDRICK PA-C
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Gender | Male
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Dates
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Enumeration Date | 01/26/2016
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Last Update Date | 03/11/2021
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Provider Practice Location Address
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Address Line | 8975 EXECUTIVE PARK DR
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City | KNOXVILLE
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State | TN
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Zip | 37923
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Country | US
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Telephone | 865-691-4100
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Fax | 865-691-6178
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Provider Business Mailing Address
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Address Line | PO BOX 1574
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City | ROSWELL
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State | NM
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Zip | 88202-1574
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Country | US
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Telephone | 575-624-3470
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Fax | 575-627-9520
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 1024
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License Number State | SD
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA2021-0018
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License Number State | NM
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Taxonomy #4
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 3070
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License Number State | TN
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