Healthcare Provider Details

I. General information

NPI: 1386963684
Provider Name (Legal Business Name): NEAL ROBERT GOODBAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2010
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22580 HIGHWAY 76 E STE 200
LAURENS SC
29360-8460
US

IV. Provider business mailing address

119 JACOBS HWY
CLINTON SC
29325-7276
US

V. Phone/Fax

Practice location:
  • Phone: 864-725-1480
  • Fax: 864-725-1481
Mailing address:
  • Phone: 864-725-1480
  • Fax: 864-725-1481

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number32611
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: