Individual
DR. DWIGHT JUSTIN GODDARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
270 GOOSEPOND RD, NEWARK, OH 43055-3104
(220) 564-7960
(220) 564-7961
Mailing address
270 GOOSEPOND RD, NEWARK, OH 43055-3104
(220) 564-7960
(220) 564-7961
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35.137356
OH
207Q00000X
Family Medicine Physician
G63539
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G63539
STATE LICENSE
CA
Enumeration date
01/17/2006
Last updated
12/12/2022
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