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:
Health care specialties
Specialty | Code | License # | 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1831186337 | NPPES |
California | MEDICAID | XPY191725 | |
California | MEDICAID | 150322 |
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