Goudelock, Gary Morgan

Goudelock, Gary Morgan is an individual health care provider with primary practice located at 20 Medical Ridge Dr , Greenville SC 29605-4267. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Goudelock, Gary Morgan can be contacted via phone (864) 220-7270.

Contact Information

Primary practice address
20 Medical Ridge Dr Greenville SC 29605-4267
Phone: (864) 220-7270
Fax: (864) 241-9211
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 10729 South Carolina

Profile Details

NPI number 1457342461
LBN Legal business name Goudelock, Gary Morgan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 31st, 2005
Last updated Jul 21st, 2022 - about 3 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 1457342461 NPPES
South Carolina MEDICAID 107299

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