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NPI Code Detail

MEDICARE: DR. BRIAN GOODMAN MD

MEDICARE: DR. BRIAN 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
1207L00000XAnesthesiology PhysicianE-7571AR

General Provider Information

NPI Number : 1851448732
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BRIAN GOODMAN MD
Provider Business Mailing Address
First Line : 3501 WE KNIGHT DR
Second Line :
City : FORT SMITH
State : AR
Zip : 72903-6254
Country : US
Telephone Number : 479-709-6755
Fax Number :
Provider Business Practice Location Address
First Line : 3501 WE KNIGHT DR
Second Line :
City : FORT SMITH
State : AR
Zip : 72903-6254
Country : US
Telephone Number : 479-709-6755
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/04/2007
Last Update Date : 06/19/2019

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