Organization
GOODMAN MEDICAL CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KARENE MARIE GOODMAN NP (COOWNER)
(573) 308-5044
Entity
Organization
Contact information
Practice address
715 STATE ROUTE CC, ROLLA, MO 65401-4402
(573) 308-5044
(573) 341-5300
Mailing address
PO BOX 918, ROLLA, MO 65402-0918
(573) 308-5044
(573) 341-5300
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500447206
—
MO
01
—
DG5099
RAILROAD MEDICARE
MO
Enumeration date
05/31/2007
Last updated
12/30/2010
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