MEDICARE: JAMES GOODSPEED 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
1	207V00000X	Obstetrics & Gynecology Physician	4301055523	MI

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568443042
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES GOODSPEED M.D.

Provider Business Mailing Address
First Line	:	601 JOHN ST
Second Line	:	SUITE N-1200
City	:	KALAMAZOO
State	:	MI
Zip	:	49007-5341
Country	:	US
Telephone Number	:	269-341-7979
Fax Number	:	269-341-6291

Provider Business Practice Location Address
First Line	:	601 JOHN ST
Second Line	:	SUITE N1200
City	:	KALAMAZOO
State	:	MI
Zip	:	49007-5341
Country	:	US
Telephone Number	:	269-341-7979
Fax Number	:	269-341-6291

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

Provider Enumeration Date	:	11/10/2005
Last Update Date	:	11/27/2023

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Directions to “ JAMES GOODSPEED M.D.” Practice Location

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