CLARENCE E GOULDING III (NPI# 1033292362) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033292362 |
| Entity Type | Individual |
| Full Name | CLARENCE E GOULDING III |
| Credential | MD |
| Practice Address |
200 Med Tech Pkwy Suite 108 Johnson City TN 37604-2278 |
| Practice Telephone | 4239155033 |
| Practice Fax Number | 4239523777 |
| Mailing Telephone | 4239155033 |
| Mailing Fax Number | 4239523777 |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2017-02-02 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 15893 | TN | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 15893 | TN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 3017571 | 05 |
| Street Address |
200 MED TECH PKWY SUITE 108 |
| City | JOHNSON CITY |
| State | TN |
| Zip Code | 37604-2278 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134185739 | Marilyn A Bishop | Preventive Medicine | 200 Med Tech Pkwy, Suite 108, Johnson City, TN 37604-2278 | 2006-04-22 |
| 1942520267 | Blue Ridge Medical Management Corporation | Clinic/Center | 200 Med Tech Pkwy, Suite 108, Johnson City, TN 37604-2278 | 2010-06-09 |
| 1366761272 | Christine N Dalton | Nurse Practitioner | 200 Med Tech Pkwy, Suite 108, Johnson City, TN 37604-2278 | 2010-05-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417560707 | Brant Logan Nickens | Physical Therapist | 809 Lamont St and Veterans Way, Johnson City, TN 37604 | 2020-08-26 |
| 1952911562 | David Sandlin Hobbs | Pharmacist | Lamont St &, Veterans Way, Johnson City, Tn 37604, Johnson City, TN 37604 | 2020-08-07 |
| 1528688272 | Whitney Marie Ward | Physical Therapist | Lamont Street and Veterans Way, Johnson City, TN 37604 | 2020-04-23 |
| 1861050015 | Akesh Thomas | Student in an Organized Health Care Education/Training Program | Johnson City Medical Center, 400 N State of Franklin Rd, Johnson City, TN 37604 | 2019-06-03 |
| 1336629021 | Medical Education Assistance Corporation | Clinic/Center | 820 W Market St, Johnson City, TN 37604 | 2018-08-21 |
| 1093208951 | Lauren Tiffany Hayden | Physician Assistant | 403 N State of Franklin Rd Woodridge Hospital, Johnson City, TN 37604 | 2018-06-14 |
| 1174014450 | Jerica Moore | Specialist/Technologist | 1041 Hamiltion Place Dr., Johnson City, TN 37604 | 2018-05-23 |
| 1053809442 | Syed Ghazanfar Hasan | Student in an Organized Health Care Education/Training Program | Etsu Psychiatry and Behavioral Sciences Department, 1276 Gilbreath Dr., Johnson City, TN 37604 | 2018-05-01 |
| 1699262485 | Sonia Kumari Oad | Student in an Organized Health Care Education/Training Program | 178 West Maple St, Johnson City, TN 37604 | 2018-04-17 |
| 1821519364 | Mahmoud El Iskandarani | Internal Medicine | 1084 W Oakland Avenue, 748, Johnson City, TN 37604 | 2017-07-06 |
| Find all providers in zip 37604 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083808885 | Tracy Martin Reece | Emergency Medicine | 611 Toll Branch Rd, Johnson City, TN 37601-5283 | 2007-09-05 |
| 1770518508 | Jamie Len Blackwell | Emergency Medicine | 409 E Chilhowie Ave, Johnson City, TN 37601-4007 | 2006-07-11 |
| 1669410304 | Emergency Care Physicians, Inc. | Emergency Medicine | 401 Princeton Rd, Johnson City, TN 37601-2028 | 2006-06-03 |
| 1942247713 | Jason Kendall Walls | Emergency Medicine | 310 North State and Franklin Road, Ste 103, Johnson City, TN 37604-6063 | 2006-06-01 |
| 1528037660 | Erin E Bryant | Emergency Medicine | 301 Med Tech Pkwy Ste 140, Johnson City, TN 37604-2364 | 2006-03-14 |
| 1487649273 | Richard Eugene Neubert | Emergency Medicine | 378 Marketplace Dr, Suite 5, Johnson City, TN 37604-2361 | 2005-09-17 |
| 1558353946 | Sabah S Toma | Emergency Medicine | 33 - 57 Harrison Street, Johnson City, NY 13790 | 2005-08-22 |
| 1538163506 | Daniel Wayne Ross | Emergency Medicine | 1408 Lake Ridge Sq, Johnson City, TN 37601-7407 | 2005-06-08 |
| 1366890279 | William Albert Galvin | Emergency Medicine | 400 N State of Franklin Rd, Johnson City, TN 37604-6035 | 2016-06-01 |
| 1942656210 | Vincent Skovira | Emergency Medicine | 507 Main St, Johnson City, NY 13790-1810 | 2016-05-05 |
| Find all providers in JOHNSON CITY | ||||
| City | JOHNSON CITY |
| Zip Code | 37604 |
Please comment or provide details below to improve the information on CLARENCE E GOULDING III.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.