Individual
EMILY KAY GOEDEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
303 E WOOD ST, SPARTANBURG, SC 29303-3020
(864) 208-8800
(864) 208-8859
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2586
SC
363A00000X
Physician Assistant
TL2586
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2686PA
—
SC
01
—
SC87746067
MEDICARE PIN
SC
01
—
SC87746121
MEDICARE PIN
SC
Enumeration date
07/13/2016
Last updated
07/21/2025
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