Healthcare Provider Details

I. General information

NPI: 1730303322
Provider Name (Legal Business Name): LAUREN FRANCES GOODMAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2007
Last Update Date: 05/19/2022
Certification Date: 02/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2050 KENNY RD STE 2200
COLUMBUS OH
43221-3502
US

IV. Provider business mailing address

700 ACKERMAN RD STE 2120
COLUMBUS OH
43202-1559
US

V. Phone/Fax

Practice location:
  • Phone: 614-293-4925
  • Fax: 614-293-5503
Mailing address:
  • Phone: 614-293-4925
  • Fax: 614-293-5503

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number35092069
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number35092069
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number35092069
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: