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Individual

DAVID TODD GOODMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
107 LEXINGTON PLZ, LEXINGTON, TN 38351-1505
(731) 968-2020
(731) 968-2866
Mailing address
PO BOX 419, LEXINGTON, TN 38351-0419
(731) 968-2020
(731) 968-2866

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD0000001762
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
13286
TLC MANAGED CARE SERVICES
TN
01
2240164
UNITED HEALTHCARE
TN
01
3044127
BLUE CROSS BLUE SHIELD
TN
05
3941001
TN
Enumeration date
02/05/2007
Last updated
12/11/2007
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