Individual
MARTHA GOODIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2508 BERT KOUNS INDUSTRIAL LOOP, SUITE 401, SHREVEPORT, LA 71118-3133
(318) 686-5440
(318) 686-0624
Mailing address
2508 BERT KOUNS INDUSTRIAL LOOP, SUITE 401, SHREVEPORT, LA 71118-3133
(318) 686-5440
(318) 686-0624
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
L#10350
LA
Other
Enumeration date
01/01/2011
Last updated
01/01/2011
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