| Mark D. Goodman | |
|
125 W 2nd Ave Suite E Hutchinson KS 67501-5300 | |
| (620) 663-4802 | |
| (620) 663-9867 |
| Full Name | Mark D. Goodman |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 125 W 2nd Ave, Hutchinson, Kansas |
| Authorized Official Name and Position | Mark D. Goodman (LICENSED PSYCHOLOGIST) |
| Authorized Official Contact | 6207276569 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mark D. Goodman 125 W 2nd Ave Suite E Hutchinson KS 67501-5300 Ph: (620) 663-4802 | Mark D. Goodman 125 W 2nd Ave Suite E Hutchinson KS 67501-5300 Ph: (620) 663-4802 |
| NPI Number | 1447565866 |
|---|---|
| Provider Enumeration Date | 08/10/2010 |
| Last Update Date | 08/10/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447565866 | NPI | - | NPPES |
| 100237680A | Medicaid | KS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 374 (Kansas) | Primary |
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