Goodroe, Randall Nix

Goodroe, Randall Nix is an individual health care provider with primary practice located at 920 Doug White Dr Ste 510 , Myrtle Beach SC 29572-4183. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Interventional Cardiology. Allopathic & Osteopathic Physicians / Interventional Cardiology is his primary health care specialty. Goodroe, Randall Nix can be contacted via phone (843) 497-7772.

Contact Information

Primary practice address
920 Doug White Dr Ste 510 Myrtle Beach SC 29572-4183
Phone: (843) 497-7772
Fax: (843) 848-7530
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 23353 South Carolina
Allopathic & Osteopathic Physicians / Interventional Cardiology 207RI0011X 23353 South Carolina

Profile Details

NPI number 1730271602
LBN Legal business name Goodroe, Randall Nix
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 29th, 2006
Last updated Jan 26th, 2022 - about 2 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 1730271602 NPPES
South Carolina Other 383781722 PRACTICE TAX ID
South Carolina MEDICAID 233535 PRACTICE TAX ID

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