Goodwin, Jeremy Dalton
Goodwin, Jeremy Dalton is an sole proprietor health care provider with primary practice located at 431 S 3Rd St , Gadsden AL 35901-5210. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Goodwin, Jeremy Dalton can be contacted via phone (256) 547-0433.Contact Information
Primary practice address
431 S 3Rd St
Gadsden AL 35901-5210
Phone: (256) 547-0433
Fax: (256) 547-0460
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 24747 | Alabama |
Profile Details
| NPI number | 1790745487 |
|---|---|
| LBN Legal business name | Goodwin, Jeremy Dalton |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 25th, 2006 |
| Last updated | Jan 18th, 2016 - about 10 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1790745487 | NPPES |
| Alabama | Other | 102I082199 | MEDICARE PTAN |
| Alabama | Other | 511-69544 | MEDICARE PTAN |
| Alabama | Other | 10270G2201 | MEDICARE PTAN |
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