IndividualActive
Jacob Goatley, MD
NPI 1235753518 · Sports Medicine (Physical Medicine & Rehabilitation) Physician · Charleston, SC
Provider details
- NPI number
- 1235753518
- Entity type
- Individual
- Primary specialty
- Sports Medicine (Physical Medicine & Rehabilitation) PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- 57.249415 (OH)
Specialties & taxonomies
- Sports Medicine (Physical Medicine & Rehabilitation) PhysicianPrimary2081S0010XLicense 57.249415 (OH)
Allopathic & Osteopathic Physicians
Student, Health Care
Practice location
135 Cannon St Ste 405
Charleston, SC 29425-3800
Phone: (843) 792-2575
Approximate (ZIP-level) locationGet directions
Mailing address
169 Ashley Ave Rm 202
Charleston, SC 29425-8905
Registry dates
- Enumerated
- 2020-06-03
- Last updated
- 2024-04-25
- Certified
- 2024-04-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.