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Contact Information

ANDREA D GOODWIN, MD
4715 24TH PL
MERIDIAN, MS39305
 Phone: 601-696-6736
 Fax: 601-696-6778
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Bariatric Medicine

207QB0002X 08 Physician/Family Practice
 

Family Medicine

207Q00000X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for ANDREA D GOODWIN · (Female)

NPI Number 1285616870
Status Active
Credentials MD
Entity Individual
Enumeration date 11/18/2005
Last updated 07/21/2022 - About 4 years ago
Sole proprietor 1 No
Identifiers
  • MS License # 17693
  • MS Medicaid 00755091
  • Other P00071956 RAILROAD MEDICARE
Hospital affiliation(s)
  • MAYO REGIONAL HOSPITAL - (Critical Access)
    897 WEST MAIN STREET
    DOVER FOXCROFT, ME 04426
  • ST DOMINIC-JACKSON MEMORIAL HOSPITAL - (Acute Care)
    969 LAKELAND DR
    JACKSON, MS 39216
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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