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Organization

WACO ORTHOPEDIC CLINIC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JON MARC GOODNIGHT M.D. (PHYSICIAN PARTNER)
(254) 752-9638
Entity
Organization

Contact information

Practice address
6600 FISH POND RD, SUITE 201, WACO, TX 76710-2581
(254) 752-9638
(254) 752-2201
Mailing address
6600 FISH POND RD, SUITE 201, WACO, TX 76710-2581
(254) 752-9638
(254) 752-2201

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
083305501
TX
Enumeration date
11/15/2006
Last updated
04/08/2008
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