MEDICARE: DR. TAYLOR J GOODWIN ND

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	175F00000X	Naturopath	2023-07	ND

General Provider Information

NPI Number	:	1396432977
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TAYLOR J GOODWIN ND

Provider Business Mailing Address
First Line	:	57900 S 600 RD
Second Line	:
City	:	KANSAS
State	:	OK
Zip	:	74347-1367
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	57900 S 600 RD
Second Line	:
City	:	KANSAS
State	:	OK
Zip	:	74347-1367
Country	:	US
Telephone Number	:	918-280-8640
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/24/2023
Last Update Date	:	04/24/2023

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