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NPI Code Detail

MEDICARE: EMILY GOODMAN MSPAS PA-C

MEDICARE: EMILY GOODMAN MSPAS PA-C
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
1363A00000XPhysician AssistantTC7155KY

General Provider Information

NPI Number : 1558254706
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY GOODMAN MSPAS PA-C
Provider Business Mailing Address
First Line : 245 FLEMINGSBURG RD
Second Line :
City : MOREHEAD
State : KY
Zip : 40351-1015
Country : US
Telephone Number : 606-780-5500
Fax Number : 606-780-2373
Provider Business Practice Location Address
First Line : 245 FLEMINGSBURG RD
Second Line :
City : MOREHEAD
State : KY
Zip : 40351-1015
Country : US
Telephone Number : 606-780-5500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/29/2025
Last Update Date : 01/20/2026

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Directions to “ EMILY GOODMAN MSPAS PA-C” Practice Location

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