Gaines, Tara Goodlett
Gaines, Tara Goodlett is an individual health care provider with primary practice located at 311 Coddle Market Dr Nw Ste 100, Concord NC 28027. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Gaines, Tara Goodlett can be contacted via phone (980) 302-9100.Contact Information
Primary practice address
311 Coddle Market Dr Nw Ste 100
Concord NC 28027
Phone: (980) 302-9100
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 200200525 | North Carolina |
Profile Details
| NPI number | 1801866355 |
|---|---|
| LBN Legal business name | Gaines, Tara Goodlett |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 26th, 2006 |
| Last updated | Jun 15th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1801866355 | NPPES |
| North Carolina | MEDICAID | 8913114 | |
| North Carolina | Other | 13114 | |
| North Carolina | Other | 1200893 | |
| North Carolina | Other | 2943796 | |
| North Carolina | Other | 800286 | |
| North Carolina | Other | 280247 | |
| North Carolina | Other | B6712 |
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