Individual
JASON EDGAR GOODIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
145 KIMEL PARK DR, SUITE 120, WINSTON SALEM, NC 27103-6984
(336) 768-3212
(336) 768-9019
Mailing address
145 KIMEL PARK DR, SUITE 120, WINSTON SALEM, NC 27103-6984
(336) 768-3212
(336) 768-9019
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
244736
NC
Other
Enumeration date
05/08/2015
Last updated
10/28/2020
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