Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | 17729 | NV |
N | 2081P2900X | Pain Medicine | 42982 | IA |
N | 2081P2900X | Pain Medicine | 48628 | AZ |
N | 2081S0010X | Sports Medicine | 48628 | AZ |
N | 213ES0000X | Sports Medicine | 48628 | AZ |
NPI | 1275851792 |
---|---|
Provider Name | Mr. Joshua James Goodwin |
First Address | Henderson, NV 89074-6393 |
Second Address | Henderson, NV 89074-6393 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2010 |
Last Update Date | 23/12/2021 |