Individual
DR. JEFFREY M GOODLOE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1145 S UTICA AVE, 6TH FLOOR - OU DEPT OF EMERGENCY MEDICINE, TULSA, OK 74104-4000
(918) 660-3822
Mailing address
1145 S. UTICA AVE, 6TH FLOOR, UNIVERSITY OF OKLAHOMA DEPARTMENT OF EMERGENCY MEDICINE, TULSA, OK 74104
(918) 660-3822
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
K5965
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
118705601
—
TX
01
—
89933K
BCBS
TX
01
—
930072620
MEDICARE RAILROAD
TX
Enumeration date
12/20/2005
Last updated
06/11/2013
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