Individual
DR. ALLYSON M. GOODMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1235 E CHEROKEE ST, SPRINGFIELD, MO 65804-2203
(417) 820-5400
Mailing address
1235 E CHEROKEE ST, SPRINGFIELD, MO 65804-2203
(417) 820-5400
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
2001001468
MO
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
2001001468
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
142262001
—
AR
05
—
205197304
—
MO
01
—
98963
AR BLUE SHIELD #
MO
Enumeration date
02/08/2007
Last updated
09/24/2018
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