Individual
CHARLES M GOODEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7001 ROGERS AVE STE 600, FORT SMITH, AR 72903-4073
(479) 573-3101
(479) 573-3102
Mailing address
7001 ROGERS AVE STE 600, FORT SMITH, AR 72903-4073
(479) 573-3101
(479) 573-3102
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
29487
AL
208600000X
Surgery Physician
Primary
E-6422
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200298850A
—
OK
Enumeration date
03/31/2006
Last updated
03/10/2023
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