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General NPI Number Information
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NPI Number | 1184666026
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Entity Type | Organization
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Legal Business Name | GOODALL-WITCHER HOSPITAL AUTHORITY
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Dates
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Enumeration Date | 06/12/2006
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Last Update Date | 05/28/2014
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Provider Practice Location Address
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Address Line | 201 POSEY AVE
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City | CLIFTON
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State | TX
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Zip | 76634-1855
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Country | US
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Telephone | 254-675-8621
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Fax | 254-675-2254
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Provider Business Mailing Address
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Address Line | PO BOX 72
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City | CLIFTON
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State | TX
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Zip | 76634-0072
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Country | US
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Telephone | 254-675-8621
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Fax | 254-675-2254
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MR. ADAM WILLMANN
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Credential |
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Telephone | 254-675-8322
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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