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Individual

JOSHUA J GOODEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
104 ALBERT AVE., SCOTT CITY, KS 67871-1216
(620) 872-0040
Mailing address
P.O. BOX 712, 104 ALBERT AVE., SCOTT CITY, KS 67871-1216
(620) 872-0040
(620) 872-0041

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1528-3
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100325510C
KS
01
410039905
RR MEDICARE
KS
01
651038
BLUE CROSS & BLUE SHIELD
KS
Enumeration date
03/01/2006
Last updated
02/26/2013
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