Provider Demographics
NPI:1194789271
Name:GOOGE, PAUL B (MD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:B
Last Name:GOOGE
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DEPARTMENT 888107
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37995-8107
Mailing Address - Country:US
Mailing Address - Phone:865-584-1933
Mailing Address - Fax:865-584-1323
Practice Address - Street 1:315 ERIN DR
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-6202
Practice Address - Country:US
Practice Address - Phone:865-584-1933
Practice Address - Fax:865-584-1323
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN15614207ZD0900X
VT042.0010674207ZD0900X
GA68780207ZD0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZD0900XAllopathic & Osteopathic PhysiciansPathologyDermatopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3043236Medicaid
TNB98894Medicare UPIN
TN3043236Medicare PIN
TN220019532Medicare PIN