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Dr. Kenneth A Goodman

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NPI Number Detailed Information

Provider Information:

Name: Dr. Kenneth A Goodman
Gender: M
Provider License Number If Given: 11807

NPI Information:

NPI: 1851394894
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 5/23/2005

Last Update Date: 7/8/2007

Provider Business Mailing Address:

Address: 5925 VENTURE PARK
Kalamazoo, MI 49009
Phone Number: 2693533700
Fax Number: 2693533701

Provider Business Practice Location Address:

Address: 5925 VENTURE PARK
Kalamazoo, MI 49009
Phone Number: 2693533700
Fax Number: 2693533701

Provider Taxonomy:

Primary: 1223G0001X
Secondary (if any):
State: MI

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