=====================================================
General NPI Number Information
=====================================================
NPI Number | 1740338482
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PAUL L GOEHRING DPM PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/08/2007
-----------------------------------------------------
Last Update Date | 04/10/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 101 DAVIS ST
-----------------------------------------------------
City | BEAVER FALLS
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15010-1241
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 724-846-0600
-----------------------------------------------------
Fax | 724-846-7535
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 101 DAVIS ST
-----------------------------------------------------
City | BEAVER FALLS
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15010-1241
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 724-846-0600
-----------------------------------------------------
Fax | 724-846-7535
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | PAUL LEROY GOEHRING
-----------------------------------------------------
Credential | DPM
-----------------------------------------------------
Telephone | 724-846-0600
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 213ES0103X
-----------------------------------------------------
Taxonomy Name | Foot & Ankle Surgery Podiatrist
-----------------------------------------------------
License Number | SC003497L
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 213EP1101X
-----------------------------------------------------
Taxonomy Name | Primary Podiatric Medicine Podiatrist
-----------------------------------------------------
License Number | SC003497L
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------