# GOODMAN MEDICAL CENTER PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104028489
- **Authorized official:** MRS. KARENE MARIE GOODMAN NP (COOWNER)
- **Authorized official phone:** (573) 308-5044

## Contact information

- **Practice address:** 715 STATE ROUTE CC, ROLLA, MO 65401-4402
- **Practice address phone:** (573) 308-5044
- **Practice address fax:** (573) 341-5300
- **Mailing address:** PO BOX 918, ROLLA, MO 65402-0918
- **Mailing address phone:** (573) 308-5044
- **Mailing address fax:** (573) 341-5300

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/31/2007
- **Last updated:** 12/30/2010