Erik Goodwin

Individual provider Active NPI Chiropractor · Pontotoc, MS

NPI 1003429176 · NPPES record last updated Aug 28, 2020

Key facts

NPI
1003429176
Entity type
Individual (NPI type 1)
Primary specialty
Chiropractor 111N00000X
License
1021 (MS)
Practice address
1 Goodwin Drive
Pontotoc, MS 38863
Phone
(662) 489-5366
Fax
(662) 842-2500
NPI assigned
Aug 28, 2020
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor
Group: 193400000X SINGLE SPECIALTY GROUP
111N00000X 1021 MS Yes

Addresses

Primary practice location

1 Goodwin Drive
Pontotoc, MS 38863

Mailing address

1 Goodwin Drive
Pontotoc, MS 38863
Phone (662) 489-5366

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL 6624895366

Other providers in Pontotoc, MS

All providers in Pontotoc, MS · Chiropractor in Mississippi

Sources for this page

Verify at the official NPI Registry.