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General NPI Number Information
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NPI Number | 1851538730
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Entity Type | Organization
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Legal Business Name | AUBURN UNIVERSITY
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Dates
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Enumeration Date | 01/14/2009
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Last Update Date | 01/14/2009
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Provider Practice Location Address
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Address Line | 349 S DONAHUE DR
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City | AUBURN
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State | AL
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Zip | 36849-0001
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Country | US
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Telephone | 334-844-9821
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Fax | 334-844-0932
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Provider Business Mailing Address
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Address Line | 349 S DONAHUE DR
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City | AUBURN
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State | AL
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Zip | 36849-0001
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Country | US
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Telephone | 334-844-9821
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Fax | 334-844-0932
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Authorized Official
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Title or Position | TEAM PHYSICIAN
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Name | DR. MICHAEL D. GOODLETT
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Credential | MD
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Telephone | 334-844-9821
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 10954
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License Number State | AL
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