Provider Demographics
NPI:1952357949
Name:GOODWIN, THOMAS C (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:C
Last Name:GOODWIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 SOUTHSIDE AVENUE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-4100
Mailing Address - Country:US
Mailing Address - Phone:828-210-2048
Mailing Address - Fax:828-277-4847
Practice Address - Street 1:90 SOUTHSIDE AVENUE
Practice Address - Street 2:SUITE 300
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-4100
Practice Address - Country:US
Practice Address - Phone:828-210-2048
Practice Address - Fax:828-277-4847
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2012-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC279152084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891268YMedicaid
C84127Medicare UPIN
NC891268YMedicaid