Marvin Jordan Godner, MD is a medicare enrolled "Pediatrics" physician in San Felipe Pueblo, New Mexico. His current practice location is
711 Pueblo Main Street, San Felipe Pueblo, New Mexico. You can reach out to his office (for appointments etc.) via phone at
(505) 867-3365.
Marvin Jordan Godner is licensed to practice in New Mexico (license number 75-38) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1164439261.
Physician's Profile
Full Name | Marvin Jordan Godner |
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Gender | Male |
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Speciality | Pediatrics |
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Location | 711 Pueblo Main Street, San Felipe Pueblo, New Mexico |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1164439261
- Provider Enumeration Date: 08/02/2006
- Last Update Date: 07/08/2007
Medicare PECOS Information:
- PECOS PAC ID: 5395000699
- Enrollment ID: I20180606003055
Medical Identifiers
Medical identifiers for Marvin Jordan Godner such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1164439261 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
208000000X | Pediatrics | 75-38 (New Mexico) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Marvin Jordan Godner is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Marvin Jordan Godner, MD 2313 Calle Colibri, Santa Fe, NM 87505-6301 Ph: (505) 983-0507 | Marvin Jordan Godner, MD 711 Pueblo Main Street, San Felipe Pueblo, NM 87001 Ph: (505) 867-3365 |
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