Individual
ANDREW GOODWYN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-S
Contact information
Practice address
114 COLLEGE AVE, ASHLAND, VA 23005
(540) 454-3164
Mailing address
300 N LOMBARDY ST APT 2A, RICHMOND, VA 23220-3532
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110011627
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/17/2025
Last updated
03/05/2026
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