Healthcare Provider Details

I. General information

NPI: 1093430654
Provider Name (Legal Business Name): GOODMAN MEDICAL SERVICES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2022
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 JUNIPER CT STE 100
BRUNSWICK GA
31520-1952
US

IV. Provider business mailing address

1089 W MISSION LN SE
DARIEN GA
31305-4951
US

V. Phone/Fax

Practice location:
  • Phone: 912-268-4633
  • Fax: 888-771-6577
Mailing address:
  • Phone: 912-230-2323
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. NEIL E GOODMAN
Title or Position: CFO
Credential: MD
Phone: 912-268-4633