MEDICARE: DR. LALCHAND T GOYAL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	01036610A	IN
2	207RC0000X	Cardiovascular Disease Physician	MD444694	PA
3	207RC0000X	Cardiovascular Disease Physician	26239	KY
4	207RC0000X	Cardiovascular Disease Physician	036067197	IL
5	207RC0000X	Cardiovascular Disease Physician	40294	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MD444694	OTHER	PA	LICENSE
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	000000388818	OTHER	KY	BCBS
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154328805
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LALCHAND T GOYAL MD

Provider Business Mailing Address
First Line	:	10 DOCTORS PARK
Second Line	:
City	:	GIBSON CITY
State	:	IL
Zip	:	60936-2009
Country	:	US
Telephone Number	:	217-784-2384
Fax Number	:	217-784-2360

Provider Business Practice Location Address
First Line	:	1109 E REELFOOT AVE STE A
Second Line	:
City	:	UNION CITY
State	:	TN
Zip	:	38261-5866
Country	:	US
Telephone Number	:	901-271-1000
Fax Number	:	901-271-4187

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	06/12/2024

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Directions to “ DR. LALCHAND T GOYAL MD” Practice Location

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