Individual
EMILY TATE GOODWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9300 DEWITT LOOP, FORT BELVOIR, VA 22060-5285
(571) 231-1994
Mailing address
ATTN: FAMILY MEDICINE, 2080 CHILD STREET, JACKSONVILLE, FL 32214
(904) 542-7300
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
0101265465
VA
207Q00000X
Family Medicine Physician
Primary
0116030331
VA
Other
Enumeration date
05/30/2017
Last updated
09/09/2021
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