Individual
JASON A. GOODIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1705 EAST BROADWAY, SUITE 280, COLUMBIA, MO 65201-7185
(573) 815-7119
(573) 815-7116
Mailing address
1705 EAST BROADWAY, SUITE 280, COLUMBIA, MO 65201-7185
(573) 815-7119
(573) 815-7116
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
2006016594
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200011712
—
MO
Enumeration date
10/05/2006
Last updated
02/28/2023
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