Individual
JEFFERY D GOODWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPH
Contact information
Practice address
2675 DECHERD BLVD, WINCHESTER, TN 37398-1166
(931) 967-0046
Mailing address
400 RIVA LAKE RD, WINCHESTER, TN 37398-4468
(931) 580-5692
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
6617
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6617
TENNESSEE BOARD OF PHARMACY
TN
Enumeration date
04/26/2018
Last updated
04/26/2018
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