Organization
GOODALL-WITCHER HOSPITAL AUTHORITY
Active
Other names
Lake Whitney Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
ADAM B WILLMANN (PRESIDENT/CEO)
(254) 675-8322
Entity
Organization
Contact information
Practice address
202 E JEFFERSON AVE, WHITNEY, TX 76692-2398
(254) 694-2221
(254) 694-9978
Mailing address
202 E JEFFERSON AVE, WHITNEY, TX 76692-2398
(254) 674-2221
(254) 694-9978
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
363AM0700X
Medical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
347012203
—
TX
Enumeration date
11/20/2014
Last updated
07/21/2022
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