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General NPI Number Information
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NPI Number | 1538318233
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Entity Type | Individual
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Provider Name | JOSHUA GOODRUM DO
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Gender | Male
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Dates
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Enumeration Date | 09/17/2008
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Last Update Date | 02/15/2024
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Provider Practice Location Address
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Address Line | 2205 ASHLAND ST STE 102
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City | ASHLAND
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State | OR
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Zip | 97520-1995
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Country | US
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Telephone | 541-526-9016
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Fax | 541-543-2491
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Provider Business Mailing Address
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Address Line | 2205 ASHLAND ST STE 102
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City | ASHLAND
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State | OR
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Zip | 97520-1995
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Country | US
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Telephone | 541-526-9016
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Fax | 541-543-2491
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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 | OS015562
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 204D00000X
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Taxonomy Name | Neuromusculoskeletal Medicine & OMM Physician
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License Number | DO197677
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License Number State | OR
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