Individual provider · Type 1 NPI

Jacob Keaton Goforth, MD

Student in an Organized Health Care Education/Training Program · Charlottesville, VA

NPI number 1689360737 Active

Practice location

1215 Lee St
Charlottesville, VA 22908-2429

Call (434) 243-5600 Map

Fax (434) 244-9450

Mailing address

1215 Lee St Box 801007
Charlottesville, VA 22908-0816

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000X0116038940 (VA)

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1689360737

Jacob Keaton Goforth, MD's National Provider Identifier is 1689360737, issued on Apr 12, 2023. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Charlottesville, VA. The record was last updated on Jun 17, 2024.