Organization
FAMILY CARE GROUP PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GISELE ALLEN GOFF MD (PRESIDENT/CEO)
(901) 377-3475
Entity
Organization
Contact information
Practice address
6555 STAGE RD, SUITE 1, BARTLETT, TN 38134-2810
(901) 377-3475
(901) 377-8068
Mailing address
PO BOX 102906, ATLANTA, GA 30368-2906
(901) 377-3475
(901) 377-8068
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31671970
BLUE CROSS GROUP PROVIDER
TN
Enumeration date
05/18/2006
Last updated
08/22/2020
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