Individual
ERIC M. GODDARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
7916 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4140
(260) 434-6322
(260) 434-6481
Mailing address
6920 POINTE INVERNESS WAY STE 200, FORT WAYNE, IN 46804-7934
(260) 479-3514
(260) 479-3520
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10002367A
IN
Other
Enumeration date
11/16/2017
Last updated
08/14/2024
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