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General NPI Number Information
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NPI Number | 1639565872
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Entity Type | Individual
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Provider Name | LINDSEY DAWN GODDARD M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/14/2015
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Last Update Date | 09/18/2025
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Provider Practice Location Address
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Address Line | 510 N 17TH AVE STE C
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City | WAUSAU
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State | WI
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Zip | 54401-4281
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Country | US
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Telephone | 715-849-5333
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Fax | 715-849-4083
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Provider Business Mailing Address
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Address Line | 801 YORK ST
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City | MANITOWOC
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State | WI
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Zip | 54220-4630
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Country | US
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Telephone | 920-663-9008
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Fax | 920-684-1439
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 1893-320
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 19657
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License Number State | ND
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Taxonomy #3
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 65556
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License Number State | AZ
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Taxonomy #4
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Taxonomy Code | 207ND0101X
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Taxonomy Name | MOHS-Micrographic Surgery Physician
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License Number | MC-1248
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License Number State | ID
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Taxonomy #5
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Taxonomy Code | 207ND0101X
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Taxonomy Name | MOHS-Micrographic Surgery Physician
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License Number | 1893-320
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License Number State | WI
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Taxonomy #6
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | MD61065973
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License Number State | WA
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Taxonomy #7
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Taxonomy Code | 207NS0135X
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Taxonomy Name | Procedural Dermatology Physician
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License Number | 1893-320
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License Number State | WI
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Taxonomy #8
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | MC-1248
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License Number State | ID
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