Individual
CRAIG W GOODSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
575 RIVERGATE, DURANGO, CO 81301-7487
(719) 648-5678
Mailing address
10 TOWN PLZ # 407, DURANGO, CO 81301-5104
(719) 648-5678
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
02628
KY
207L00000X
Anesthesiology Physician
Primary
DR.0045552
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64002223
—
KY
Enumeration date
08/26/2005
Last updated
02/10/2017
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