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Individual

KEVIN D GOODLOW

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5885 GLENRIDGE DR NE, SUITE 200, ATLANTA, GA 30328-5512
(404) 252-7526
(404) 851-1709
Mailing address
5885 GLENRIDGE DR NE, SUITE 200, ATLANTA, GA 30328-5512
(404) 252-7526
(404) 851-1709

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
057977
GA
208M00000X
Hospitalist Physician
057977
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
761536854A
GA
Enumeration date
09/14/2006
Last updated
05/15/2013
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