Organization
PELVIC HEALTH AND MENOPAUSE CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NATHAN WAYNE GOODYEAR M.D. (DOCTOR)
(318) 255-3223
Entity
Organization
Contact information
Practice address
411 E VAUGHN AVE, SUITE 201, RUSTON, LA 71270-5972
(318) 255-3223
(318) 255-3181
Mailing address
411 E VAUGHN AVE, SUITE 201, RUSTON, LA 71270-5972
(318) 255-3223
(318) 255-3181
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
MD.201086
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1538166970
NPI
—
01
—
33779
CONTROLLED DRUG NUMBER
LA
01
—
MD.201086
STATE LICENSE NUMBER
LA
Enumeration date
03/09/2007
Last updated
03/07/2023
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