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Individual
DR. KENNETH BASIL GODSEY
Active
Individual
DR. KENNETH BASIL GODSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
H1774
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010054856
RR MEDICARE
TX
05
—
0980039-03
—
TX
Enumeration date
08/19/2006
Last updated
12/20/2022
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