Organization
SHEA GODWIN MD PSC
Active
Other names
Godwin Family Practice
Organization subpart
No
Provider details
NPI number
Authorized official
SHEA A GODWIN MD (OWNER)
(270) 522-6963
Entity
Organization
Contact information
Practice address
250 MAIN ST, SUITE E, CADIZ, KY 42211-9153
(270) 522-6963
(270) 522-7231
Mailing address
250 MAIN ST, SUITE E, CADIZ, KY 42211-9153
(270) 522-6963
(270) 522-7231
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1096567
USA MANAGED CARE ORGANIZATION
KY
01
—
1538257910
PROVIDER NPI
KY
Enumeration date
05/31/2008
Last updated
08/12/2008
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