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General NPI Number Information
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NPI Number | 1457385924
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Entity Type | Individual
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Provider Name | MEREDITH ANN GOODWIN M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/10/2006
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Last Update Date | 04/05/2019
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Provider Practice Location Address
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Address Line | 10535 HOSPITAL WAY BLDG 650
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City | MATHER
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State | CA
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Zip | 95655-4200
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Country | US
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Telephone | 916-843-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 1115 W CALL ST DEPT. FAMILY MEDICINE/RURAL HEALTH, FSU COLL OF MEDICIN
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City | TALLAHASSEE
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State | FL
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Zip | 32304-3556
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Country | US
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Telephone | 850-644-9454
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Fax | 850-645-2859
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | G064592
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License Number State | CA
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