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Organization

THOMAS F. GOODALL, D. O., INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. THOMAS FREDERICK GOODALL D.O. (PRESIDENT)
(937) 723-3525
Entity
Organization

Contact information

Practice address
425 W GRAND AVE, SUITE 3003, DAYTON, OH 45405-4775
(937) 226-7890
(937) 461-4156
Mailing address
425 W GRAND AVE, SUITE 3003, DAYTON, OH 45405-4775
(937) 226-7890
(937) 461-4156

Taxonomy

Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
34002454
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000070362
ANTHEM
05
0457858
OH
01
0620007
UNITED HEALTHCARE
01
123879100
FEDERAL BWC
05
64044050
KY
Enumeration date
02/24/2014
Last updated
02/24/2014
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