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General NPI Number Information
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NPI Number | 1063489425
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Entity Type | Individual
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Provider Name | JOHN GODDARD M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/03/2006
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Last Update Date | 06/27/2025
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Provider Practice Location Address
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Address Line | 400 MATTHEW ST STE 302
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City | MARIETTA
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State | OH
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Zip | 45750-1656
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Country | US
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Telephone | 740-568-5207
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Fax | 740-434-0578
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Provider Business Mailing Address
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Address Line | 600 18TH ST SUITE 512
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City | PARKERSBURG
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State | WV
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Zip | 26101-3231
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Country | US
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Telephone | 304-424-4574
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Fax | 304-424-4429
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | 20468
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License Number State | WV
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