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General NPI Number Information
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NPI Number | 1144823550
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Entity Type | Individual
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Provider Name | JEFFEY JOHN GOETZINGER R. PH.
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Gender | Male
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Dates
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Enumeration Date | 11/18/2020
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Last Update Date | 11/18/2020
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Provider Practice Location Address
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Address Line | 3816 W CHESTNUT EXPY
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City | SPRINGFIELD
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State | MO
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Zip | 65802-5500
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Country | US
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Telephone | 417-868-8288
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Fax | 417-868-8248
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Provider Business Mailing Address
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Address Line | 3321 S HILLSBORO AVE
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City | SPRINGFIELD
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State | MO
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Zip | 65804-4862
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Country | US
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Telephone | 417-350-8912
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 042745
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License Number State | MO
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