Organization
R CHARLES GOODMAN, JR, OD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROY C GOODMAN JR. O.D. (MEMBER)
(334) 750-3831
Entity
Organization
Contact information
Practice address
1110 EASTDALE MALL, MONTGOMERY, AL 36117-2144
(334) 272-4722
(334) 272-5096
Mailing address
1110 EASTDALE MALL, MONTGOMERY, AL 36117-2144
(334) 272-4722
(334) 272-5096
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
S729-TA155
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
143416
—
AL
Enumeration date
01/23/2015
Last updated
01/23/2015
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