Goodman, Mark Stephen

Goodman, Mark Stephen is an individual health care provider with primary practice located at 2900 Daggett Ave , Klamath Falls OR 97601-7101. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Goodman, Mark Stephen can be contacted via phone (541) 884-1371.

Contact Information

Primary practice address
2900 Daggett Ave Klamath Falls OR 97601-7101
Phone: (541) 884-1371
Fax: (541) 882-3862
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X MD20502 Oregon
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X MD20502 Oregon

Profile Details

NPI number 1831186337
LBN Legal business name Goodman, Mark Stephen
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 30th, 2005
Last updated Sep 28th, 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 1831186337 NPPES
California MEDICAID XPY191725
California MEDICAID 150322

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