Individual
MR. CHARLES GOSHEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1101 W LIBERTY ST, FARMINGTON, MO 63640-1921
(573) 756-6751
Mailing address
1134 TRAILRIDGE DR, JACKSON, MO 63755-3507
(735) 429-2251
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
110789
MO
Other
Enumeration date
05/03/2007
Last updated
12/09/2021
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