Individual
CONNY DALE GOODIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
115 CROSSFIELD DR STE A, VERSAILLES, KY 40383-1845
(859) 873-9843
(859) 873-0972
Mailing address
115 CROSSFIELD DR STE A, VERSAILLES, KY 40383-1845
(859) 873-9843
(859) 873-0972
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
20159
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000047824
ANTHEM BLUE SHIELD
KY
01
—
0037674
MEDICARE - FAYETTE COUNTY HEALTH DEPARTMENT
KY
01
—
0400358
UNITED HEALTHCARE
KY
01
—
110031155
RAILROAD MEDICARE
KY
01
—
1284109
UMWA
KY
01
—
1404232
UMWA
KY
01
—
611012421
ESSENCE
KY
01
—
611012421D
HUMANA
KY
05
—
64-201593
—
KY
01
—
D95905
BLUEGRASS FAMILY HEALTH
KY
Enumeration date
08/24/2005
Last updated
01/18/2022
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