Goderwis, Douglas
Goderwis, Douglas is an individual health care provider with primary practice located at 7300 Turfway Rd , Florence KY 41042-1375. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Goderwis, Douglas can be contacted via phone (859) 212-4700.Contact Information
Primary practice address
7300 Turfway Rd
Florence KY 41042-1375
Phone: (859) 212-4700
Fax: (859) 212-4761
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 27947 | Kentucky |
Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 27947 | Kentucky |
Profile Details
NPI number | 1760439095 |
---|---|
LBN Legal business name | Goderwis, Douglas |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | May 30th, 2006 |
Last updated | May 2nd, 2024 - about 7 months 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 | 1760439095 | NPPES |
Ohio | MEDICAID | 0723542 | |
Ohio | MEDICAID | 64279474 |
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