Provider Demographics
NPI:1952381832
Name:GOSWITZ, HELEN VODOPICK (MD)
Entity Type:Individual
Prefix:
First Name:HELEN
Middle Name:VODOPICK
Last Name:GOSWITZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:HELEN
Other - Middle Name:
Other - Last Name:VODOPICK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:170 W TENNESSEE AVE
Mailing Address - Street 2:
Mailing Address - City:OAK RIDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37830
Mailing Address - Country:US
Mailing Address - Phone:865-483-7411
Mailing Address - Fax:865-483-7413
Practice Address - Street 1:170 W TENNESSEE AVE
Practice Address - Street 2:
Practice Address - City:OAK RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37830
Practice Address - Country:US
Practice Address - Phone:865-483-7411
Practice Address - Fax:865-483-7413
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5413207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3374883Medicaid
3128236Medicare ID - Type Unspecified
TN3374883Medicaid