Goodykoontz, Toni B

Goodykoontz, Toni B is an sole proprietor health care provider with primary practice located at 1400 Johnson Ave Suite 4H, Bridgeport WV 26330-1063. She recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as her primary health care specialty. Goodykoontz, Toni B can be contacted via phone (304) 842-1990.

Contact Information

Primary practice address
1400 Johnson Ave Suite 4H Bridgeport WV 26330-1063
Fax: (304) 842-4471
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 15898 West Virginia

Profile Details

NPI number 1659378354
LBN Legal business name Goodykoontz, Toni B
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 7th, 2005
Last updated Mar 29th, 2013 - about 13 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 1659378354 NPPES
West Virginia MEDICAID 0115011000

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