Organization
PROVIDENT HEALTH SERVICES, INC.
Active
Other names
Lloyd S. Goodman, M.D.
Organization subpart
No
Provider details
NPI number
Authorized official
ROBIN J. MADDOX (PROVIDER ENROLLMENT COORDINATOR)
(912) 350-9335
Entity
Organization
Contact information
Practice address
1101 LEXINGTON AVE, SAVANNAH, GA 31404-5502
(912) 350-8222
(912) 350-8686
Mailing address
PO BOX 933213, ATLANTA, GA 31193-3213
(912) 350-8222
(912) 350-8686
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Enumeration date
12/12/2006
Last updated
11/12/2007
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