Provider Demographics
NPI:1760482848
Name:GOEHRING, PAUL L (DPM)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:L
Last Name:GOEHRING
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 DAVIS ST
Mailing Address - Street 2:
Mailing Address - City:BEAVER FALLS
Mailing Address - State:PA
Mailing Address - Zip Code:15010-1241
Mailing Address - Country:US
Mailing Address - Phone:724-846-0600
Mailing Address - Fax:724-846-7535
Practice Address - Street 1:101 DAVIS ST
Practice Address - Street 2:
Practice Address - City:BEAVER FALLS
Practice Address - State:PA
Practice Address - Zip Code:15010-1241
Practice Address - Country:US
Practice Address - Phone:724-846-0600
Practice Address - Fax:724-846-7535
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-29
Last Update Date:2007-10-26
Deactivation Date:2006-03-22
Deactivation Code:
Reactivation Date:2006-03-30
Provider Licenses
StateLicense IDTaxonomies
PASC003497L213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012168660003Medicaid
PA629333Medicare ID - Type Unspecified
5868070001Medicare NSC
PAU03131Medicare UPIN