Godfrey, John R

Godfrey, John R is an individual health care provider with primary practice located at 1230 N Duquesne Rd , Joplin MO 64801-1509. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Godfrey, John R can be contacted via phone (417) 782-1443.

Contact Information

Primary practice address
1230 N Duquesne Rd Joplin MO 64801-1509
Fax: (417) 782-3240
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 00721 Missouri

Profile Details

NPI number 1952484073
LBN Legal business name Godfrey, John R
Credentials M.S.
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 23rd, 2006
Last updated Jul 8th, 2007 - about 17 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 1952484073 NPPES
Missouri MEDICAID 493306310

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