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General NPI Number Information
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NPI Number | 1801327838
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Entity Type | Individual
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Provider Name | ELLIOTT GOODWIN DO
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Gender | Male
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Dates
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Enumeration Date | 03/22/2017
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Last Update Date | 06/10/2025
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Provider Practice Location Address
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Address Line | 1819 CLINCH AVE STE 108
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City | KNOXVILLE
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State | TN
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Zip | 37916-2435
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Country | US
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Telephone | 865-546-5111
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Fax | 865-374-2095
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Provider Business Mailing Address
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Address Line | 1819 CLINCH AVE STE 108
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City | KNOXVILLE
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State | TN
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Zip | 37916-2435
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Country | US
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Telephone | 865-546-5111
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Fax | 865-374-2095
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | R4408
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number | 6269
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License Number State | TN
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