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General NPI Number Information
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NPI Number | 1811976046
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Entity Type | Individual
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Provider Name | ALLISON H GOODLETT M.D.
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Gender | Female
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Dates
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Enumeration Date | 01/16/2006
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Last Update Date | 03/21/2012
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Provider Practice Location Address
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Address Line | 4701 SPOTSYLVANIA PARKWAY SUITE 200
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City | FREDERICKSBURG
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State | VA
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Zip | 22408
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Country | US
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Telephone | 540-834-5430
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Fax | 540-834-5431
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Provider Business Mailing Address
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Address Line | PO BOX 1460
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City | FREDERICKSBURG
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State | VA
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Zip | 22402-1460
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Country | US
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Telephone | 540-786-2100
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Fax | 540-786-0677
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 0101238185
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License Number State | VA
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