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Individual

TAMI M GODDARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP-C

Contact information

Practice address
240 SHERATON BLVD, MACON, GA 31210-1358
(478) 471-1943
(478) 475-9780
Mailing address
240 SHERATON BLVD, MACON, GA 31210-1358
(478) 471-1943
(478) 475-9780

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN165613
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003127596
GA
Enumeration date
09/06/2012
Last updated
07/03/2013
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