Individual
DR. BRENT GOODGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1200 MEMORIAL DR, DALTON, GA 30720-2529
(706) 259-4435
(706) 226-2283
Mailing address
PO BOX 2563, DALTON, GA 30722-2563
(706) 259-4435
(706) 226-2283
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
56067
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00278407
RAILROAD MEDICARE
GA
Enumeration date
06/14/2005
Last updated
08/03/2023
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