Gooch, Jerry Burton

Gooch, Jerry Burton is an individual health care provider with primary practice located at 6027 Walnut Grove Rd Suite 203, Memphis TN 38120-2145. He recently has only one registered license in Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery), which is considered as his primary health care specialty. Gooch, Jerry Burton can be contacted via phone (901) 226-5957.

Contact Information

Primary practice address
6027 Walnut Grove Rd Suite 203 Memphis TN 38120-2145
Phone: (901) 226-5957
Fax: (901) 226-5940
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) 208G00000X 10805 Tennessee

Profile Details

NPI number 1558305557
LBN Legal business name Gooch, Jerry Burton
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 16th, 2006
Last updated Oct 21st, 2016 - about 9 years ago

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558305557 NPPES
Mississippi MEDICAID 09016196
Mississippi MEDICAID 201015716

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