Individual
BRUCE RANDOLPH GOODMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5651 FRIST BLVD, STE. 201, HERMITAGE, TN 37076-2054
(615) 391-0800
(615) 391-0431
Mailing address
5651 FRIST BLVD, STE. 201, HERMITAGE, TN 37076-2054
(615) 391-0800
(615) 391-0431
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
MD0000014977
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0057723
BLUE CROSS
TN
01
—
MD0000014977
STATE ID NUMBER
TN
Enumeration date
09/20/2005
Last updated
07/08/2007
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