Goddard, Mark Kimball

Goddard, Mark Kimball is an individual health care provider with primary practice located at 5121 S. Cottonwood Street Imc, Division Of Pulmonary/Ccm, Murray UT 84107. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Critical Care Medicine, Allopathic & Osteopathic Physicians / Pulmonary Disease. Allopathic & Osteopathic Physicians / Critical Care Medicine is his primary health care specialty. Goddard, Mark Kimball can be contacted via phone (801) 507-4000.

Contact Information

Primary practice address
5121 S. Cottonwood Street Imc, Division Of Pulmonary/Ccm Murray UT 84107
Phone: (801) 507-4000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Critical Care Medicine 207RC0200X MD26606 Oregon
Allopathic & Osteopathic Physicians / Critical Care Medicine 207RC0200X MD00046412 Washington
Allopathic & Osteopathic Physicians / Critical Care Medicine 207RC0200X 293990-1205 Utah
Allopathic & Osteopathic Physicians / Pulmonary Disease 207RP1001X MD26606 Oregon
Allopathic & Osteopathic Physicians / Pulmonary Disease 207RP1001X MD00046412 Washington
Allopathic & Osteopathic Physicians / Pulmonary Disease 207RP1001X 293990-1205 Utah

Profile Details

NPI number 1124101621
LBN Legal business name Goddard, Mark Kimball
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 20th, 2006
Last updated Jan 21st, 2009 - about 15 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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