Provider Demographics
NPI:1093938763
Name:GOFFE, GREGORY A (DC)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:A
Last Name:GOFFE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 REGENCY RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45459-4251
Mailing Address - Country:US
Mailing Address - Phone:937-435-1895
Mailing Address - Fax:937-435-1884
Practice Address - Street 1:380 REGENCY RIDGE DR
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45459-4251
Practice Address - Country:US
Practice Address - Phone:937-435-1895
Practice Address - Fax:937-435-1884
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1792111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000020645OtherANTHEM
OH0807661OtherAETNA
OH0968458Medicaid
OH44-20167OtherUNITED HEALTHCARE
OH0807661OtherAETNA
OH0711742Medicare PIN