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Individual

DR. CARL G GOODMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1455 E BERT KOUNS INDUSTRIAL LOOP STE 210, SHREVEPORT, LA 71105-6000
(318) 798-4623
(318) 798-4568
Mailing address
1455 E BERT KOUNS LOOP, SHREVEPORT, LA 71105-5634
(318) 798-4623
(318) 798-4646

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
009524
LA
207X00000X
Orthopaedic Surgery Physician
009524
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1053315846
GROUP NPI NUMBER
LA
05
1095699
LA
01
200020143
RAILROAD MEDICARE NUMBER
LA
Enumeration date
06/09/2005
Last updated
02/02/2026
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