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General NPI Number Information
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NPI Number | 1114002011
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Entity Type | Individual
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Provider Name | WILLIAM H. GOODIN JR. M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/26/2006
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Last Update Date | 06/16/2008
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Provider Practice Location Address
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Address Line | 12 HOSPITAL CIR STE B
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City | BATESVILLE
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State | AR
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Zip | 72501-7310
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Country | US
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Telephone | 870-793-2841
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Fax |
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Provider Business Mailing Address
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Address Line | 3295 ALICE DR
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City | BATESVILLE
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State | AR
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Zip | 72501-6306
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Country | US
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Telephone | 870-793-2841
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Fax |
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | C-4821
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License Number State | AR
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