JOHN GORDON GODDARD

SHREVEPORT, LA
NPI1629008214
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: LA  15478R)
Additional Taxonomies207Q00000X Family Medicine
(Licence: VA  0101057937)
Enumeration Date2006-07-03
Last Update Date2007-10-31
Business Address
JOHN GORDON GODDARD MD
1666 E BERT KOUNS INDUSTRIAL LOOP SUITE 105
SHREVEPORT, LA 71105-5714
Phone number: 318-212-3750
Mailing Address
JOHN GORDON GODDARD MD
1666 E BERT KOUNS INDUSTRIAL LOOP SUITE 105
SHREVEPORT, LA 71105-5714
Phone number: 318-212-3750
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