Individual
MARY K GOODWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
103 N MAIN ST, CHENEY, KS 67025-8844
(316) 540-6190
Mailing address
PO BOX 9291, WICHITA, KS 67277-0291
(316) 721-4669
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
04-18112
KS
Other
Enumeration date
03/30/2006
Last updated
10/04/2016
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