Individual
MR. JAMES A GOUDY II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
270 PORTLAND WAY S, GALION, OH 44833
(419) 468-8323
(419) 462-5567
Mailing address
700 N COLUMBUS ST, CRESTLINE, OH 44827-1455
(419) 468-0511
(419) 468-8579
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35057542G
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000371100
ANTHEM BCBS
OH
05
—
0747124
—
OH
Enumeration date
01/20/2006
Last updated
12/30/2020
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