Goodridge, Sophia D

Goodridge, Sophia D is an sole proprietor health care provider with primary practice located at 2500 Hospital Blvd Ste 290 , Roswell GA 30076. She recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as her primary health care specialty. Goodridge, Sophia D can be contacted via phone (470) 956-4230.

Contact Information

Primary practice address
2500 Hospital Blvd Ste 290 Roswell GA 30076
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X 52077 Kentucky
Allopathic & Osteopathic Physicians / Urology 208800000X 82831 Georgia

Profile Details

NPI number 1255690905
LBN Legal business name Goodridge, Sophia D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 15th, 2012
Last updated Jun 10th, 2019 - about 5 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 1255690905 NPPES
Kentucky MEDICAID 7100580160

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