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General NPI Number Information
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NPI Number | 1821156787
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Entity Type | Organization
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Legal Business Name | MATTHEW KIRK GOODING MD
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Dates
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Enumeration Date | 12/04/2006
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Last Update Date | 05/03/2011
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Provider Practice Location Address
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Address Line | 246 CATALINA DR STE 5
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City | ASHLAND
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State | OR
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Zip | 97520-1624
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Country | US
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Telephone | 541-488-3221
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Fax | 541-488-5884
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Provider Business Mailing Address
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Address Line | 246 CATALINA DR. STE 5
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City | ASHLAND
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State | OR
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Zip | 97520-1624
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Country | US
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Telephone | 541-488-3221
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Fax | 541-488-5884
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Authorized Official
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Title or Position | OWNER
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Name | DR. MATTHEW KIRK GOODING
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Credential | MD
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Telephone | 541-488-3221
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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 | MD08203
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License Number State | OK
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