Douglas Goodwin, DO is a medicare enrolled "Student In An Organized Health Care Education/training Program" in Chattanooga, Tennessee. His current practice location is
1100 E 3rd St, Chattanooga, Tennessee. You can reach out to his office (for appointments etc.) via phone at
(423) 778-2957.
Douglas Goodwin is licensed to practice in * (Not Available) (license number ) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1013488337.
Provider's Profile
| Full Name | Douglas Goodwin |
|---|
| Gender | Male |
|---|
| Speciality | Student In An Organized Health Care Education/training Program |
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| Location | 1100 E 3rd St, Chattanooga, Tennessee |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
|---|
NPI Data:
- NPI Number: 1013488337
- Provider Enumeration Date: 12/14/2018
- Last Update Date: 03/27/2025
Medicare PECOS Information:
- PECOS PAC ID: 4082954912
- Enrollment ID: I20190612004015
Medical Identifiers
Medical identifiers for Douglas Goodwin such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1013488337 | NPI | - | NPPES |
| 000211956C | Medicaid | GA | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363LF0000X | Nurse Practitioner - Family | RN224028 (Georgia) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Douglas Goodwin is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Douglas Goodwin, DO
1100 E 3rd St,
Chattanooga, TN 37403-2241
Ph: (423) 778-2957 | Douglas Goodwin, DO
1100 E 3rd St,
Chattanooga, TN 37403-2241
Ph: (423) 778-2957 |
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