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Individual

DR. DAN CLARK GODBEE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
7777 HENNESSY BLVD, SUITE 200, BATON ROUGE, LA 70808-4300
(800) 684-0857
Mailing address
5513 JANE MARIE ST, ZACHARY, LA 70791-2606
(225) 654-9971

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
025402
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
025402
STATE MEDICAL LICENSE
LA
05
1575429
LA
01
P01182803
RAILROAD MCARE
Enumeration date
06/10/2006
Last updated
07/30/2013
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