| Doctor Name: | DR. GREG R. GOODMAN |
| NPI Number: | 1023019346 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 179027-1205 |
| Business Practice Address: | 5323 S. Woodrow Street #102 Murray, UT - 84107 |
| Business Phone Number: | 8017131010 |
| Business Fax Number: | 8017130665 |
| Mailing Address: | 5444 Green St, SALT LAKE CITY |
| State: | UT |
| Postal Code: | 841235632 |
| Phone Number: | 8012841702 |
| Fax Number: | 8012623897 |
| NPI Enumeration Date: | 08/09/2005 |
| NPI Last Update Date: | 05/31/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2086S0129X |
| License Number: | 179027-1205 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | UT |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Surgery |
| Taxonomy Specialization: | Vascular Surgery |
| Taxonomy Definition: | A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |