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Individual

DALE E GOINS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
302 E 20TH ST, HOPE, AR 71801-8217
(870) 777-8975
(870) 777-8294
Mailing address
PO BOX 1447, HOPE, AR 71802-1447
(870) 777-8475
(870) 777-8294

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
C5744
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
080178792
RAILROAD MEDICARE
05
102-612-001
AR
01
14169000001
QUAL CHOICE
01
51920
BLUE CROSS
01
710614761
TRICARE
Enumeration date
10/26/2005
Last updated
07/08/2007
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