Provider Demographics
NPI:1619425303
Name:GOODING, RACHEL GLORE (PA-C)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:GLORE
Last Name:GOODING
Suffix:
Gender:F
Credentials:PA-C
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1705
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30903-1705
Mailing Address - Country:US
Mailing Address - Phone:706-854-6008
Mailing Address - Fax:706-774-7230
Practice Address - Street 1:1348 WALTON WAY STE 6700
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30901-5111
Practice Address - Country:US
Practice Address - Phone:706-774-7855
Practice Address - Fax:706-774-8620
Is Sole Proprietor?:No
Enumeration Date:2016-09-12
Last Update Date:2022-08-10
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant