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Search › Indiana › 103TC0700X

Evan Goodman

NPI 1588107569 · on the registry since 2016

Practice

Address
909 E State Blvd
Fort Wayne, IN 46805
Phone
(260) 482-9125
Organisation at this address
Park Center Inc
Park Center Inc
Park Center, Inc.
Genoa Healthcare Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
274

Registry record

Primary taxonomy
103TC0700X
103TC0700X
Licence states on file
IN
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2018-11-26

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Indiana