Individual
SHEA A. GODWIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
250 MAIN ST., SUITE E, CADIZ, KY 42211
(270) 522-6963
(270) 522-7231
Mailing address
250 MAIN ST., SUITE E, CADIZ, KY 42211
(270) 522-6963
(270) 522-7231
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
41486
KY
207Q00000X
Family Medicine Physician
Primary
41486
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1096567
USA MANAGED CARE ORGANIZATION
—
01
—
1538257910
INDIVIDUAL NPI
KY
01
—
1881852317
GROUP NPI
KY
01
—
41486
KY LICENSE
KY
05
—
7100013780
—
KY
Enumeration date
10/10/2006
Last updated
09/21/2023
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