| NPI Details | |
|---|---|
| NPI | 1659313864 |
| Gender | Male |
| Enumeration Date | 06/12/2006 |
| Last Updated | 11/04/2010 |
| Entity Type | Individual |
| Active | Over 11 years ago |
| Practice Location | |
|---|---|
| 809 UNIVERSITY BLVD E TUSCALOOSA AL, 35401-2029, US |
|
| Phone | (205) 759-7352 |
| Fax | (205) 759-6397 |
| Business Location | |
|---|---|
| 809 UNIVERSITY BLVD E TUSCALOOSA AL, 35401-2029, US |
|
| Phone | (205) 759-7352 |
| Fax | (205) 759-6397 |
| Toxanomy | |
|---|---|
| Taxonomy Code | 163W00000X |
| License State | Alabama |
| License Number | 1-031210 |
| Remove 1659313864 NPI Number | |
According to our database, Randy Jerome Goodwin CRNA NPI is 1659313864, taxonomy code is 163W00000X and license number is 1-031210, license state is located at Alabama. Randy Jerome Goodwin CRNA physically located at 809 University Blvd E, Tuscaloosa AL, 35401-2029. NPI Number Randy Jerome Goodwin CRNA has the Individual type.
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1659313864 NPI number is provided on an as is basis without warranty of any kind. 1659313864 is maintained by the National Plan & Provider Enumeration System. The contents of Randy Jerome Goodwin CRNA are for informational purposes only.
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