Goodyear, Constance M

Goodyear, Constance M is an individual health care provider with primary practice located at 805 Hall St , Wiggins MS 39577-2110. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Goodyear, Constance M can be contacted via phone (601) 928-4412.

Contact Information

Primary practice address
805 Hall St Wiggins MS 39577-2110
Phone: (601) 928-4412
Fax: (601) 928-4792
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 14719 Mississippi

Profile Details

NPI number 1669482824
LBN Legal business name Goodyear, Constance M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 9th, 2006
Last updated Mar 26th, 2009 - 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 1669482824 NPPES
Other P00120058 RAILROAD MEDICARE
MEDICAID 00116736 RAILROAD MEDICARE
Other 640507572BB RAILROAD MEDICARE

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