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General NPI Number Information
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NPI Number | 1942498308
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Entity Type | Organization
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Legal Business Name | ROBERT T GOETZINGER MD PC
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Dates
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Enumeration Date | 10/11/2007
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Last Update Date | 04/08/2008
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Provider Practice Location Address
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Address Line | 131 UPPER RIVERDALE RD SW
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City | RIVERDALE
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State | GA
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Zip | 30274-2540
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Country | US
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Telephone | 770-994-9913
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Fax | 770-994-0706
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Provider Business Mailing Address
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Address Line | 131 UPPER RIVERDALE RD SW
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City | RIVERDALE
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State | GA
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Zip | 30274-2540
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Country | US
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Telephone | 770-994-9913
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Fax | 770-994-0706
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROBERT T GOETZINGER
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Credential | M.D.
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Telephone | 770-994-9913
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 018141
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License Number State | GA
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