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Individual

JOHN A GODFREY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
914 N DIXIE AVE, STE 304, ELIZABETHTOWN, KY 42701-2520
(270) 769-1049
(270) 735-1978
Mailing address
914 N DIXIE AVE, STE 304, ELIZABETHTOWN, KY 42701-2520
(270) 769-1049
(270) 735-1978

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
36738
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
64033905
KY
Enumeration date
11/04/2005
Last updated
12/23/2009
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