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NPI Code Detail

MEDICARE: BRETT PATRICK GODBOUT M.D.

MEDICARE:   BRETT PATRICK GODBOUT  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207X00000XOrthopaedic Surgery PhysicianMD041621LPA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
9200007508OTHERRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10427799000OTHERAMERIHEALTH
21353362OTHERCIGNA HEALTHCARE
3328815OTHERHEALTH AMERICA/HEALTH ASS
40427799000OTHERKEYSTONE HEALTH EAST
51459385OTHERPRIVATE HEALTHCARE SYSTEM
6605276OTHERFIRST PRIORITY LIFE INS.
7819550OTHERFIRST PRIORITY HEALTH
8MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10328815OTHERHIGHMARK BLUE SHIELD
1101195901OTHERKEYSTONE HEALTH CENTRAL
12088884OTHERAETNA
132170505OTHERMAMSI
140427799000OTHERINDEPENDENCE BLUE CROSS
1550044348OTHERCAPITAL BLUE CROSS
1613294OTHERGEISINGER HEALTH PLAN
171553795OTHERUNITED HEALTHCARE
18P379431OTHEROXFORD HEALTH PLANS

General Provider Information

NPI Number : 1184621948
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRETT PATRICK GODBOUT M.D.
Provider Business Mailing Address
First Line : 1605 N CEDAR CREST BLVD STE 411
Second Line :
City : ALLENTOWN
State : PA
Zip : 18104-2323
Country : US
Telephone Number : 484-884-4500
Fax Number : 484-884-0699
Provider Business Practice Location Address
First Line : 2775 SCHOENERSVILLE RD
Second Line :
City : BETHLEHEM
State : PA
Zip : 18017-7307
Country : US
Telephone Number : 610-861-8080
Fax Number : 610-807-0366
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2005
Last Update Date : 08/22/2022

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