Provider Demographics
NPI:1457325052
Name:GOFF, JAMES D (DO)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:D
Last Name:GOFF
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:515 UNION AVE.
Mailing Address - Street 2:SUITE 167
Mailing Address - City:DOVER
Mailing Address - State:OH
Mailing Address - Zip Code:44622
Mailing Address - Country:US
Mailing Address - Phone:330-343-3335
Mailing Address - Fax:330-364-5720
Practice Address - Street 1:515 UNION AVE.
Practice Address - Street 2:SUITE 167
Practice Address - City:DOVER
Practice Address - State:OH
Practice Address - Zip Code:44622
Practice Address - Country:US
Practice Address - Phone:330-343-3335
Practice Address - Fax:330-364-5720
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2016-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34007211G207QA0505X
OH34007211207QS0010X
OH34-00-72112081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
No207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2436144Medicaid
OH2157366OtherGROUP MEDICAID
OH2436144Medicaid
OH2157366OtherGROUP MEDICAID