Provider Demographics
NPI:1851386866
Name:GOEHRING, LOUIS A III (MD)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:A
Last Name:GOEHRING
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:980 SANDERS RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-5977
Mailing Address - Country:US
Mailing Address - Phone:770-886-1074
Mailing Address - Fax:770-205-4717
Practice Address - Street 1:980 SANDERS RD
Practice Address - Street 2:SUITE 100
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-5977
Practice Address - Country:US
Practice Address - Phone:770-886-1074
Practice Address - Fax:770-205-4717
Is Sole Proprietor?:No
Enumeration Date:2005-09-15
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA033335174400000X, 208600000X
GA33335208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000448786DMedicaid
GA000448786EMedicaid
GA000448786FMedicaid
GA000448786FMedicaid
GAC51985Medicare UPIN