Provider Demographics
NPI:1790847036
Name:GOINS, JASON D
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:D
Last Name:GOINS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:244 N PETERS RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-4933
Mailing Address - Country:US
Mailing Address - Phone:865-694-6132
Mailing Address - Fax:865-694-6143
Practice Address - Street 1:244 N PETERS RD
Practice Address - Street 2:SUITE 203
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4933
Practice Address - Country:US
Practice Address - Phone:865-694-6132
Practice Address - Fax:865-694-6143
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN5201247100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic Technologist