MARK KIMBALL GODDARD

MURRAY, UT
NPI1124101621
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207RC0200X Internal Medicine, Critical Care Medicine
(Licence: UT  293990-1205)
Additional Taxonomies207RC0200X Internal Medicine, Critical Care Medicine
(Licence: OR  MD26606)
207RC0200X Internal Medicine, Critical Care Medicine
(Licence: WA  MD00046412)
207RP1001X Internal Medicine, Pulmonary Disease
(Licence: OR  MD26606)
207RP1001X Internal Medicine, Pulmonary Disease
(Licence: WA  MD00046412)
207RP1001X Internal Medicine, Pulmonary Disease
(Licence: UT  293990-1205)
Enumeration Date2006-10-20
Last Update Date2009-01-21
Business Address
-- MARK KIMBALL GODDARD M.D.
5121 S. COTTONWOOD STREET IMC, DIVISION OF PULMONARY/CCM
MURRAY, UT 84107
Phone number: 801-507-4000
Mailing Address
-- MARK KIMBALL GODDARD M.D.
5121 S. COTTONWOOD STREET IMC, DIVISION OF PULMONARY/CCM
MURRAY, UT 84123
Phone number: 801-507-4000