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General NPI Number Information
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NPI Number | 1780026484
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Entity Type | Organization
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Legal Business Name | GOODWIN AND GOODWIN PLLC
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Dates
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Enumeration Date | 07/23/2013
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Last Update Date | 07/23/2013
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Provider Practice Location Address
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Address Line | 1444 CLIFF GOOKIN BLVD
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City | TUPELO
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State | MS
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Zip | 38801-6477
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Country | US
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Telephone | 662-842-2500
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Fax | 662-842-2500
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Provider Business Mailing Address
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Address Line | 1444 CLIFF GOOKIN BLVD
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City | TUPELO
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State | MS
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Zip | 38801-6477
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Country | US
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Telephone | 662-842-2500
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Fax | 662-842-2500
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Authorized Official
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Title or Position | OWNER/DOCTOR
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Name | ROBERT LEN GOODWIN
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Credential | DC
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Telephone | 662-842-2500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 82
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License Number State | MS
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