Provider Demographics
NPI:1770009698
Name:GO DOC GO PLLC
Entity Type:Organization
Organization Name:GO DOC GO PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORGANIZER/MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:DOOHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:704-999-0275
Mailing Address - Street 1:413 RUNNING HORSE LN
Mailing Address - Street 2:
Mailing Address - City:WAXHAW
Mailing Address - State:NC
Mailing Address - Zip Code:28173
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:413 RUNNING HORSE LN
Practice Address - Street 2:
Practice Address - City:WAXHAW
Practice Address - State:NC
Practice Address - Zip Code:28173-7232
Practice Address - Country:US
Practice Address - Phone:704-999-0275
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-22
Last Update Date:2017-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2006-00826207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty