Organization
PROVIDENT HEALTH SERVICES, INC.
Active
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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