Individual
DR. THOMAS EDWARD GOODRICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6015 DURAND AVE, SUITE 500, MT PLEASANT, WI 53406-5089
(262) 456-1000
Mailing address
6015 DURAND AVE, SUITE 500, MOUNT PLEASANT, WI 53406-5089
(262) 456-1000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
28720
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30830700
—
WI
Enumeration date
05/19/2007
Last updated
10/07/2014
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