Organization
ADVANCED EAR NOSE & THROAT, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RONALD JEFFREY GOODELL D.O. (PRESIDENT)
(314) 239-3527
Entity
Organization
Contact information
Practice address
1201 S DOUGLAS BLVD, SUITE L, MIDWEST CITY, OK 73130-5239
(314) 239-3527
Mailing address
972 SUNBURST CT, BALLWIN, MO 63021-6937
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
4473
OK
Other
Enumeration date
01/11/2007
Last updated
04/27/2010
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