Goodenow, Gary

Goodenow, Gary is an individual health care provider with primary practice located at 303 N Clyde Morris Blvd , Daytona Beach FL 32114-2709. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Goodenow, Gary can be contacted via phone (386) 254-4121.

Contact Information

Primary practice address
303 N Clyde Morris Blvd Daytona Beach FL 32114-2709
Phone: (386) 254-4121
Fax: (386) 258-4802
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X ME44693 Florida

Profile Details

NPI number 1346309416
LBN Legal business name Goodenow, Gary
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 6th, 2006
Last updated Apr 5th, 2010 - about 16 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 1346309416 NPPES
Florida MEDICAID 252074500
Florida Other ME44693

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