Individual
DR. MARK J GOEDKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1515 42ND ST NE, CEDAR RAPIDS, IA 52402-3061
(319) 365-7581
(319) 365-0163
Mailing address
1515 42ND ST NE, CEDAR RAPIDS, IA 52402-3061
(319) 365-7581
(319) 365-0163
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
31916
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4140400
—
IA
Enumeration date
09/22/2005
Last updated
06/23/2022
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