Goodwin, Jeremy Dalton

Goodwin, Jeremy Dalton is an sole proprietor health care provider with primary practice located at 431 S 3Rd St , Gadsden AL 35901-5210. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Goodwin, Jeremy Dalton can be contacted via phone (256) 547-0433.

Contact Information

Primary practice address
431 S 3Rd St Gadsden AL 35901-5210
Phone: (256) 547-0433
Fax: (256) 547-0460
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 24747 Alabama

Profile Details

NPI number 1790745487
LBN Legal business name Goodwin, Jeremy Dalton
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 25th, 2006
Last updated Jan 18th, 2016 - about 8 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 1790745487 NPPES
Alabama Other 102I082199 MEDICARE PTAN
Alabama Other 511-69544 MEDICARE PTAN
Alabama Other 10270G2201 MEDICARE PTAN

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