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Individual

ROBERT EMORY GOODMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
740 JORDAN ST, SHREVEPORT, LA 71101-4616
(318) 424-9240
(318) 424-0022
Mailing address
740 JORDAN ST, SHREVEPORT, LA 71101-4616
(318) 424-9240
(318) 424-0022

Taxonomy

Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
15562
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
110043608
RAILROAD MEDICARE
LA
05
1348465
LA
Enumeration date
11/17/2005
Last updated
07/14/2011
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