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General NPI Number Information
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NPI Number | 1841316809
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Entity Type | Organization
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Legal Business Name | D JOHN GODEHN, JR., M.D., P.A.
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Dates
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Enumeration Date | 03/22/2007
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Last Update Date | 09/26/2011
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Provider Practice Location Address
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Address Line | 506 PARK HILL CT SUITE 1
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City | HENDERSONVILLE
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State | NC
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Zip | 28739-4265
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Country | US
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Telephone | 828-693-0275
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Fax |
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Provider Business Mailing Address
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Address Line | 506 PARK HILL CT SUITE 1
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City | HENDERSONVILLE
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State | NC
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Zip | 28739-4265
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Country | US
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Telephone | 828-693-0275
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DONALD JOHN GODEHN JR.
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Credential | M.D.
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Telephone | 828-693-0275
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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 | 21561
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License Number State | NC
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