Individual
DR. GREG R. GOODMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5323 S. WOODROW STREET, #102, MURRAY, UT 84107
(801) 713-1010
(801) 713-0665
Mailing address
5444 GREEN ST, SALT LAKE CITY, UT 84123-5632
(801) 284-1702
(801) 262-3897
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
179027-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
D0968
—
UT
Enumeration date
08/09/2005
Last updated
05/31/2012
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