Organization
RAYMOND C. GOODMAN, O.D., P.A.
Active
Other names
Eyecare Center of Gooding PA
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAYMOND CLYDE GOODMAN O.D. (PRESIDENT)
(208) 934-4856
Entity
Organization
Contact information
Practice address
317 MAIN ST, GOODING, ID 83330-1302
(208) 934-4856
(208) 934-5818
Mailing address
317 MAIN ST, GOODING, ID 83330-1302
(208) 934-4856
(208) 934-5818
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ODP-100008
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4776340001
DMERC
ID
01
—
DA2306
RAILROAD MEDICARE
ID
Enumeration date
03/14/2007
Last updated
01/28/2011
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