Goedjen, Brent Thomas

Goedjen, Brent Thomas is an individual health care provider with primary practice located at 135 Norcross St , Roswell GA 30075-3867. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Dermatology. Allopathic & Osteopathic Physicians / Dermatology is his primary health care specialty. Goedjen, Brent Thomas can be contacted via phone (678) 870-2020.

Contact Information

Primary practice address
135 Norcross St Roswell GA 30075-3867
Fax: (262) 203-9631
Website:

Profile Details

NPI number 1912292657
LBN Legal business name Goedjen, Brent Thomas
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 10th, 2011
Last updated Jul 22nd, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1912292657 NPPES
Florida MEDICAID 009270000

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