Individual
DR. ANDREW S GOGGIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
308 W COLLEGE AVE, GREENVILLE, IL 62246
(618) 664-0771
(618) 664-3915
Mailing address
308 W COLLEGE AVE, GREENVILLE, IL 62246
(618) 664-0271
(618) 664-3915
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
036108090
IL
207Q00000X
Family Medicine Physician
Primary
036108090
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036108090
—
IL
05
—
036108090-2
—
IL
05
—
1336123165
—
MO
Enumeration date
12/05/2005
Last updated
12/13/2023
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