Provider Demographics
NPI:1073775706
Name:GOERS, TRUDIE A (MD)
Entity Type:Individual
Prefix:
First Name:TRUDIE
Middle Name:A
Last Name:GOERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 42ND AVE N STE 400
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37209-3658
Mailing Address - Country:US
Mailing Address - Phone:615-329-7887
Mailing Address - Fax:615-340-4537
Practice Address - Street 1:410 42ND AVE N STE 400
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37209-3658
Practice Address - Country:US
Practice Address - Phone:615-329-7887
Practice Address - Fax:615-340-4537
Is Sole Proprietor?:No
Enumeration Date:2008-06-25
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD46598208600000X
MO2004013300208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1521977Medicaid
TN103I1028697Medicare PIN