MEDICARE: DR. CARL G GOODMAN MD

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
1	174400000X	Specialist	009524	LA
2	207X00000X	Orthopaedic Surgery Physician	009524	LA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	200020143	OTHER	LA	RAILROAD MEDICARE NUMBER

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	1053315846	OTHER	LA	GROUP NPI NUMBER

General Provider Information

NPI Number	:	1346244290
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CARL G GOODMAN MD

Provider Business Mailing Address
First Line	:	1455 E BERT KOUNS LOOP
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71105-5634
Country	:	US
Telephone Number	:	318-798-4623
Fax Number	:	318-798-4646

Provider Business Practice Location Address
First Line	:	1455 E BERT KOUNS INDUSTRIAL LOOP STE 210
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71105-6000
Country	:	US
Telephone Number	:	318-798-4623
Fax Number	:	318-798-4568

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	02/02/2026

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Directions to “ DR. CARL G GOODMAN MD” Practice Location

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