Goodwin, Jeremy Lr
Goodwin, Jeremy Lr is an sole proprietor health care provider with primary practice located at 1456 Professional Dr Ste 402 , Petaluma CA 94954-6639. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Neurology, Allopathic & Osteopathic Physicians / Pain Medicine. Allopathic & Osteopathic Physicians / Neurology is his primary health care specialty. Goodwin, Jeremy Lr can be contacted via phone (707) 938-7951.Contact Information
Primary practice address
1456 Professional Dr Ste 402
Petaluma CA 94954-6639
Phone: (707) 938-7951
Fax: (707) 938-7260
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | G76323 | California |
| Allopathic & Osteopathic Physicians / Pain Medicine | 208VP0000X | G76323 | California |
Profile Details
| NPI number | 1366547614 |
|---|---|
| LBN Legal business name | Goodwin, Jeremy Lr |
| Credentials | MS, MD |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 13th, 2006 |
| Last updated | Jun 6th, 2023 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1366547614 | NPPES |
| Oregon | Other | R113031 | NORIDAN |
| Oregon | Other | 138326 | NORIDAN |
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