Individual
THOMAS JOSEPH GOODENOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1221 S BROADWAY, LEXINGTON, KY 40504-2701
(859) 258-4401
(859) 258-4418
Mailing address
1221 S BROADWAY, LEXINGTON, KY 40504-2701
(859) 258-4401
(859) 258-4418
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
18990
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
37903705
MEDICAID LAB GROUP
KY
01
—
4000501
MEDICARE LAB GROUP
KY
05
—
64189905
—
KY
01
—
CB5773
RR MEDICARE GROUP
KY
Enumeration date
07/05/2006
Last updated
11/02/2007
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