Goddard, Michael William

Goddard, Michael William is an individual health care provider with primary practice located at 130 N Broadway Ave Ste 300 , Shawnee OK 74801-6939. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Goddard, Michael William can be contacted via phone (405) 395-0399.

Contact Information

Primary practice address
130 N Broadway Ave Ste 300 Shawnee OK 74801-6939
Phone: (405) 395-0399
Fax: (405) 395-0330
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 10925 Oklahoma

Profile Details

NPI number 1285665109
LBN Legal business name Goddard, Michael William
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 6th, 2006
Last updated Jan 11th, 2023 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285665109 NPPES
Oklahoma MEDICAID 100094730D

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