Individual
MRS. HADDEN F GOODMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
23 ELKRUN HWY 89, ALPINE, WY 83128
(307) 654-7138
(307) 654-7201
Mailing address
P.O. BOX 3047, ALPINE, WY 83128
(307) 654-7138
(307) 654-7201
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
433
WY
363A00000X
Physician Assistant
WY433
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
605960009
USDLAB
WY
Enumeration date
08/25/2007
Last updated
04/24/2012
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