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Individual
KEITH GODFREY
Active
Individual
KEITH GODFREY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
O-1761
ID
390200000X
Student in an Organized Health Care Education/Training Program
Primary
O-1761
ID
Other
Enumeration date
03/31/2021
Last updated
05/01/2026
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