Individual
JONATHAN M GOODIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
804 DIXIE ST, CARROLLTON, GA 30117-4416
(770) 834-0606
(770) 834-1833
Mailing address
119 AMBULANCE DR, SUITE 202, CARROLLTON, GA 30117-3857
(770) 834-0606
(770) 834-1833
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
58474
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000084170
—
AL
Enumeration date
04/26/2006
Last updated
06/18/2010
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