Provider Demographics
NPI:1053560086
Name:CHERYL R. GOYNE, M.D. LLC
Entity type:Organization
Organization Name:CHERYL R. GOYNE, M.D. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:R
Authorized Official - Last Name:GOYNE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-358-1848
Mailing Address - Street 1:644 2ND ST NE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ALABASTER
Mailing Address - State:AL
Mailing Address - Zip Code:35007-8824
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:644 2ND ST NE
Practice Address - Street 2:SUITE 101
Practice Address - City:ALABASTER
Practice Address - State:AL
Practice Address - Zip Code:35007-8824
Practice Address - Country:US
Practice Address - Phone:205-358-1848
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-15
Last Update Date:2011-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009912318Medicaid
AL009912318Medicaid
AL510I130002Medicare PIN