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General NPI Number Information
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NPI Number | 1033676119
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Entity Type | Organization
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Legal Business Name | DR. GEORGE GOODMAN, INC.
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Dates
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Enumeration Date | 02/26/2019
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Last Update Date | 02/26/2019
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Provider Practice Location Address
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Address Line | 720 S COLORADO BLVD STE 140A
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City | DENVER
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State | CO
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Zip | 80246-1916
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Country | US
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Telephone | 303-607-0174
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Fax | 303-607-0149
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Provider Business Mailing Address
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Address Line | 1431 SKY ROCK WAY
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City | CASTLE ROCK
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State | CO
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Zip | 80109-3691
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Country | US
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Telephone | 405-245-9333
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR (OPTOMETRIST)
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Name | DR. GEORGE EDWARD GOODMAN
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Credential | OD
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Telephone | 405-245-9333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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