Individual
DR. CHARLES JEFFERY GOODWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
101 HOSPITAL BLVD, JEFFERSONVILLE, IN 47130-3769
(812) 282-3899
Mailing address
101 HOSPITAL BLVD, JEFFERSONVILLE, IN 47130-3769
(812) 282-3899
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
01061089A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000565585
ANTHEM FACET
—
01
—
01061089A
MEDICAL LICENSE
IN
05
—
200913700
—
IN
01
—
41679
MEDICAL LICENSE
KY
05
—
7100059660
—
KY
Enumeration date
03/18/2007
Last updated
02/18/2014
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