Doctor Name: | DR. JEFFREY CURTIS GOODMAN |
NPI Number: | 1699025924 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 02137 |
Business Practice Address: | 5454 Kahiliholo Road Kilauea, HI - 96754 |
Business Phone Number: | 8088281470 |
Business Fax Number: | |
Mailing Address: | P O Box 148, KILAUEA |
State: | HI |
Postal Code: | 96754 |
Phone Number: | 8088281470 |
Fax Number: | |
NPI Enumeration Date: | 09/13/2012 |
NPI Last Update Date: | 09/13/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207QA0505X |
License Number: | 02137 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | HI |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Family Medicine |
Taxonomy Specialization: | Adult Medicine |
Taxonomy Definition: |