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General NPI Number Information
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NPI Number | 1447274741
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Entity Type | Individual
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Provider Name | JOHN ROBERT GODKE MD
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Gender | Male
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Dates
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Enumeration Date | 07/27/2006
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Last Update Date | 02/10/2017
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Provider Practice Location Address
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Address Line | 5825 AIRLINE HWY EKL HOSPITAL
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City | BATON ROUGE
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State | LA
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Zip | 70805
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Country | US
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Telephone | 225-381-2755
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Fax | 225-381-2759
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Provider Business Mailing Address
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Address Line | 8585 PICARDY AVE SUITE 313
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City | BATON ROUGE
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State | LA
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Zip | 70809
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Country | US
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Telephone | 225-635-6916
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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 | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | MD.025376
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | MD.025376
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License Number State | LA
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