Provider Demographics
NPI:1982676292
Name:GOINS, MAURICE LAMONT (MD)
Entity Type:Individual
Prefix:DR
First Name:MAURICE
Middle Name:LAMONT
Last Name:GOINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:6635 LAKE DRIVE
Mailing Address - Street 2:
Mailing Address - City:MORROW
Mailing Address - State:GA
Mailing Address - Zip Code:30260
Mailing Address - Country:US
Mailing Address - Phone:770-968-1323
Mailing Address - Fax:770-968-4556
Practice Address - Street 1:1336 WEST HIGHWAY 54
Practice Address - Street 2:BLDG 500
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30214
Practice Address - Country:US
Practice Address - Phone:770-461-1238
Practice Address - Fax:770-460-6610
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA058745207X00000X, 207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
I71369Medicare UPIN
GA20NCCSLMedicare PIN