Provider Demographics
NPI:1952411399
Name:GOGGANS, DONALD S (MD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:S
Last Name:GOGGANS
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 1:220 RESEARCH DR
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30605-2738
Mailing Address - Country:US
Mailing Address - Phone:706-583-2870
Mailing Address - Fax:706-369-5877
Practice Address - Street 1:220 RESEARCH DR
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30605-2738
Practice Address - Country:US
Practice Address - Phone:706-583-2870
Practice Address - Fax:706-369-5877
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA495702083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000931631AMedicaid
SCG49570Medicaid
H51989Medicare UPIN
GA000931631AMedicaid