Individual
DR. SCOTT T GOODRICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2514 E DUPONT RD STE 100, FORT WAYNE, IN 46825-1619
(260) 484-8830
(260) 483-1911
Mailing address
PO BOX 749495, ATLANTA, GA 30374-9495
(855) 963-2100
(239) 236-2775
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
01078092A
IN
207VX0201X
Gynecologic Oncology Physician
Primary
01078092A
IN
Other
Enumeration date
03/15/2007
Last updated
12/04/2024
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