Organization
MICHELLE M GODFREY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHELLE GODFREY DO (PRESIDENT)
(870) 405-0382
Entity
Organization
Contact information
Practice address
901 BURNETT DR, MOUNTAIN HOME, AR 72653-2908
(870) 424-4935
Mailing address
PO BOX 305, MOUNTAIN HOME, AR 72654-0305
(870) 405-0382
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
E-2846
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
145191003
—
AR
Enumeration date
09/08/2015
Last updated
09/08/2015
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