GOODMAN MEDICAL CENTER PC NPI 1104028489

NPI Information

NPI: 1104028489
Provider Name: GOODMAN MEDICAL CENTER PC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
715 STATE ROUTE CC
ROLLA, MO
ZIP 65401
Phone: (573) 308-5044
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GOODMAN MEDICAL CENTER PC is a family medicine in Rolla, MO. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. GOODMAN MEDICAL CENTER PC NPI is 1104028489. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

715 STATE ROUTE CC
ROLLA, MO
ZIP 65401-402
Phone: (573) 308-5044
Fax: (573) 341-5300

The provider's authorized official is Karene Marie Goodman .
The authorized official title is Coowner and has the following contact phone number (573) 308-5044.

The enumeration date for this NPI number is 5/31/2007 and was last updated on 12/30/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207Q00000X	Family Medicine				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	DG5099	OTHER	MISSOURI	RAILROAD MEDICARE
2	990001376	MEDICARE ID-TYPE UNSPECIFIED	MISSOURI	GROUP NUMBER
3	500447206	MEDICAID	MISSOURI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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