Provider Demographics
NPI:1245397611
Name:LOUIS A. GOEHRING, III MD PC
Entity Type:Organization
Organization Name:LOUIS A. GOEHRING, III MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:GOEHRING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:706-864-7500
Mailing Address - Street 1:PO BOX 4207
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31208-4207
Mailing Address - Country:US
Mailing Address - Phone:706-864-7500
Mailing Address - Fax:706-864-7588
Practice Address - Street 1:199 MOUNTAIN DR
Practice Address - Street 2:SUITE 200
Practice Address - City:DAHLONEGA
Practice Address - State:GA
Practice Address - Zip Code:30533-1607
Practice Address - Country:US
Practice Address - Phone:706-864-7500
Practice Address - Fax:706-864-7588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GADB2520OtherRAIL ROAD MEDICARE GROUP
GADB2520OtherRAIL ROAD MEDICARE GROUP