Cisco-Goff, Jodi M

Cisco-Goff, Jodi M is an individual health care provider with primary practice located at 77 Hospital Dr , Logan WV 25601-3451. She recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as her primary health care specialty. Cisco-Goff, Jodi M can be contacted via phone (304) 792-1847.

Contact Information

Primary practice address
77 Hospital Dr Logan WV 25601-3451
Phone: (304) 792-1847
Fax: (304) 792-1849
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 20768 West Virginia

Profile Details

NPI number 1497714737
LBN Legal business name Cisco-Goff, Jodi M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 23rd, 2006
Last updated Dec 3rd, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1497714737 NPPES
Kentucky MEDICAID 64050750
Kentucky MEDICAID 1812173000
Kentucky MEDICAID 2327762

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