Individual
MICHAEL D GOODLETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
10954
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51521101
BLUE CROSS
AL
Enumeration date
03/09/2006
Last updated
05/18/2009
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