Individual
JEREMY T GOODWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
97 MARTIN LUTHER KING JR DR, FORSYTH, GA 31029-1648
(478) 994-1010
(478) 994-1080
Mailing address
97 MARTIN LUTHER KING JR DR, FORSYTH, GA 31029-1648
(478) 994-1010
(478) 994-1080
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
059416
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
841584607A
—
GA
Enumeration date
05/14/2007
Last updated
09/16/2013
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