Goddard, Jesse
Goddard, Jesse is an sole proprietor health care provider with primary practice located at 300 Pine Grove Cmns , York PA 17403-5176. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Trauma Surgery, Allopathic & Osteopathic Physicians / Surgical Critical Care. Allopathic & Osteopathic Physicians / Surgical Critical Care is his primary health care specialty. Goddard, Jesse can be contacted via phone (717) 851-6110.Contact Information
Primary practice address
300 Pine Grove Cmns
York PA 17403-5176
Phone: (717) 851-6110
Fax: (717) 741-1076
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | MD459118 | Pennsylvania |
| Allopathic & Osteopathic Physicians / Trauma Surgery | 2086S0127X | 46080 | Kentucky |
| Allopathic & Osteopathic Physicians / Surgical Critical Care | 2086S0102X | MD459118 | Pennsylvania |
Profile Details
| NPI number | 1093917221 |
|---|---|
| LBN Legal business name | Goddard, Jesse |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 1st, 2007 |
| Last updated | Jul 21st, 2022 - about 2 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 | 1093917221 | NPPES |
| Pennsylvania | MEDICAID | 103179835 | |
| Pennsylvania | Other | PO1804579 |
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