Individual
J ROGER GOODWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1325 ANDREA ST, SUITE 201, BOWLING GREEN, KY 42104-5852
(270) 781-7212
(270) 781-7772
Mailing address
1325 ANDREA ST, SUITE 201, BOWLING GREEN, KY 42104-5852
(270) 781-7212
(270) 781-7772
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
14457
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64144579
—
KY
Enumeration date
05/09/2006
Last updated
08/22/2007
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