# CLAY COUNTY PODIATRY, LLC

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

## Provider details

- **NPI number:** 1972532125
- **Authorized official:** DR. MIRANDA ANNE GOODALE DPM (MANAGING MEMBER)
- **Authorized official phone:** (812) 448-9290

## Contact information

- **Practice address:** 955 W CRAIG AVE, BRAZIL, IN 47834-7400
- **Practice address phone:** (812) 448-9290
- **Practice address fax:** (812) 448-9296
- **Mailing address:** 955 W CRAIG AVE, BRAZIL, IN 47834-7400
- **Mailing address phone:** (812) 448-9290
- **Mailing address fax:** (812) 448-9296

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | 07001015A | IN | Yes |

## Other

- **Enumeration date:** 07/01/2006
- **Last updated:** 05/31/2019