Individual
CHAD AARON GOODWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-1000
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-1000
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R887247
MS
367500000X
Certified Registered Nurse Anesthetist
Primary
R887247
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02725317
—
MS
Enumeration date
02/02/2011
Last updated
07/15/2016
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