Provider Demographics
NPI:1932157369
Name:GOEKE, JOSEPH A IV (MD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:A
Last Name:GOEKE
Suffix:IV
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 E MCBEE AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-2842
Mailing Address - Country:US
Mailing Address - Phone:864-695-6697
Mailing Address - Fax:
Practice Address - Street 1:1005 GROVE RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-4630
Practice Address - Country:US
Practice Address - Phone:864-455-6900
Practice Address - Fax:864-255-5619
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2025-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003012640207RC0000X
SC95393207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200372570BMedicaid
KS200372570CMedicaid
KS200372570AMedicaid
KS200372570EMedicaid
KSP00842604OtherRAILROAD MEDICARE
MOP00842663OtherRAILROAD MEDICARE
KSKA1021011OtherMEDICARE - CUSHING
MO201083805Medicaid
KS200372570DMedicaid
KS200372570BMedicaid
KSKA2004014Medicare PIN
I49984Medicare UPIN
KS200372570DMedicaid
MOMA2492036Medicare PIN