| Goodman Medical Center Pc | |
|
715 State Route Cc Rolla MO 65401-4402 | |
| (573) 308-5044 | |
| (573) 341-5300 |
| Full Name | Goodman Medical Center Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 715 State Route Cc, Rolla, Missouri |
| Authorized Official Name and Position | Karene Marie Goodman (COOWNER) |
| Authorized Official Contact | 5733085044 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Goodman Medical Center Pc Po Box 918 Rolla MO 65402-0918 Ph: (573) 308-5044 | Goodman Medical Center Pc 715 State Route Cc Rolla MO 65401-4402 Ph: (573) 308-5044 |
| NPI Number | 1104028489 |
|---|---|
| Provider Enumeration Date | 05/31/2007 |
| Last Update Date | 12/30/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104028489 | NPI | - | NPPES |
| 500447206 | Medicaid | MO | |
| DG5099 | Other | MO | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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