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General NPI Number Information
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NPI Number | 1588694913
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Entity Type | Individual
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Provider Name | MITCHELL H. GOLDMAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/03/2006
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Last Update Date | 10/25/2011
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Provider Practice Location Address
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Address Line | 1940 ALCOA HWY SUITE 120
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City | KNOXVILLE
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State | TN
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Zip | 37920-2244
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Country | US
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Telephone | 865-305-9244
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Fax | 865-305-6958
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Provider Business Mailing Address
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Address Line | 1924 ALCOA HIGHWAY BOX U-11
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City | KNOXVILLE
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State | TN
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Zip | 37920
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Country | US
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Telephone | 865-305-9244
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Fax | 865-305-6958
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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 | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 0015871
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License Number State | TN
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