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General NPI Number Information
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NPI Number | 1609148832
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Entity Type | Organization
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Legal Business Name | HOSPITAL INPATIENT SERVICES OF WINSLOW LLC
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Dates
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Enumeration Date | 02/03/2012
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Last Update Date | 12/29/2013
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Provider Practice Location Address
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Address Line | 1501 N WILLIAMSON AVE
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City | WINSLOW
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State | AZ
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Zip | 86047-2735
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Country | US
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Telephone | 928-289-4691
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Fax |
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Provider Business Mailing Address
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Address Line | 13737 NOEL RD STE 1600
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City | DALLAS
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State | TX
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Zip | 75240-1331
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Country | US
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Telephone | 469-401-2386
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Fax | 214-712-2444
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DONALD GODBOLD
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Credential | M.D.
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Telephone | 469-401-2386
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number |
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License Number State |
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