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Contact Information

RAYMOND C GOODMAN, OD
317 MAIN ST
GOODING, ID83330-1302
 Phone: 208-934-4856
 Fax: 208-934-5818
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for RAYMOND C GOODMAN · (Male)

NPI Number 1407859739
Status Active
Credentials OD (Doctor of Optometry)
Entity Individual
Enumeration date 05/31/2005
Last updated 03/09/2011 - About 15 years ago
Sole proprietor 1 No
Identifiers
  • ID License # ODP-100008
  • ID Medicaid 806370300
  • ID Other V050-0 BLUE CROSS
  • ID Other 000010138989 REGENCE BLUE SHIELD
Hospital affiliation(s) Not Available
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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