Individual
DR. JENNIFER CELESTE GOODFRED
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
8970 WINCHESTER RD, MEMPHIS, TN 38125-8231
(901) 794-5806
(901) 794-7922
Mailing address
9398 DOGWOOD RD S, GERMANTOWN, TN 38139-5737
(901) 378-4705
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1711
TN
207Q00000X
Family Medicine Physician
24106
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003181844A
—
GA
05
—
01203728
—
MS
05
—
1205878105
—
MO
05
—
187976003
—
AR
05
—
3319805
—
TN
05
—
7100484990
—
KY
Enumeration date
06/12/2006
Last updated
05/10/2022
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