Individual
BRENT W GODEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1700 GEARY ST SE, ALBANY, OR 97322-6842
(541) 812-5570
(541) 812-5699
Mailing address
PO BOX 1188, CORVALLIS, OR 97339-1188
(541) 812-5570
(541) 812-5699
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD151050
OR
Other
Enumeration date
12/08/2005
Last updated
11/03/2020
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