Individual
JODI M CISCO-GOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
77 HOSPITAL DR, LOGAN, WV 25601-3451
(304) 792-1847
(304) 792-1849
Mailing address
1600 MEDICAL CENTER DR, SUITE 2500, HUNTINGTON, WV 25701-3656
(304) 691-1200
(304) 691-1287
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
20768
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1812173000
—
WV
05
—
2327762
—
OH
05
—
64050750
—
KY
Enumeration date
03/23/2006
Last updated
12/03/2021
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