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Contact Information

KEITH G GOODFELLOW, MD
147 REYNOIR ST STE 105
BILOXI, MS39530
 Phone: 228-436-6674
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Obstetrics & Gynecology

207V00000X 16 Physician/Obstetrics & Gynecology
Indicates primary specialty

NPI Profile & details for KEITH G GOODFELLOW · (Male)

NPI Number 1164573515
Status Active
Credentials MD
Entity Individual
Enumeration date 01/14/2007
Last updated 05/14/2019 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • MS License # 13840
  • MS Medicaid 06474210
Hospital affiliation(s)
  • BILOXI REGIONAL MEDICAL CENTER - (Acute Care)
    150 REYNOIR STREET
    BILOXI, MS 39530
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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