DR. KEITH G GOODFELLOW (NPI# 1164573515) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164573515 |
| Entity Type | Individual |
| Full Name | DR. KEITH G GOODFELLOW |
| Credential | MD |
| Practice Address |
147 Reynoir St Ste 105 Biloxi MS 39530 |
| Mailing Address |
Po Box 321359 Flowood MS 39232-1359 |
| Practice Telephone | 2284366674 |
| Mailing Telephone | 6019361395 |
| Mailing Fax Number | 6019361260 |
| Enumeration Date | 2007-01-14 |
| Last Update Date | 2019-05-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | 13840 | MS | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 06474210 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4577 13th St, Gulfport, MS 395012516 | 2288642752 |
| Street Address |
147 REYNOIR ST STE 105 |
| City | BILOXI |
| State | MS |
| Zip Code | 39530 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588158125 | Gulf Coast Anesthesia Associates | Anesthesiology | 147 Reynoir St Ste 305, Biloxi, MS 39530 | 2018-06-18 |
| 1326486804 | Pavilion Personal Care LLC | In Home Supportive Care | 1450b Beach Blvd, Biloxi, MS 39530 | 2013-06-06 |
| 1366707713 | Makeva K Reed | Nurse Practitioner | 321 Division St, Biloxi, MS 39530 | 2012-07-11 |
| 1174833602 | Keith Edward Earley Jr. | Ophthalmology | 301 Fisher Ave, Keesler Afb, MS 39530 | 2010-10-18 |
| 1730406729 | Alexander H. Nguyen | Surgery | 4503 M St, Biloxi, MS 39530 | 2010-04-29 |
| 1881891265 | Tina Fleming Mcgrew | Nurse Practitioner | 321-b Divison Street, Biloxi, MS 39530 | 2007-06-29 |
| 1285857623 | South Mississippi Nephrology, Pllc | Internal Medicine | 784 Vieux Marche, Biloxi, MS 39530 | 2007-04-11 |
| 1871640292 | Doreen Brock | Nurse Practitioner | 1046 Division Street, Biloxi, MS 39530 | 2007-01-05 |
| 1922069715 | Garvin Wallace Cunningham | Dentist | 683 Division St, Biloxi, MS 39530 | 2006-03-31 |
| 1306813126 | William E Malone | Optometrist | 683 Division Street, Biloxi, MS 39530 | 2006-03-01 |
| Find all providers in zip 39530 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427062884 | Hebe Arroyo Diaz | Obstetrics & Gynecology | 1720a Medical Park Drive, Suite 130c, Biloxi, MS 39532 | 2006-07-28 |
| 1013947951 | Kathryn Mcclure, Md, P.l.l.c. | Obstetrics & Gynecology | 1720a Medical Park Dr Ste 130a, Biloxi, MS 39532-2122 | 2006-07-04 |
| 1720025968 | Shahira Hanna | Obstetrics & Gynecology | 2781 C T Switzer Sr Drive, Ste 302, Biloxi, MS 39531-4535 | 2006-05-31 |
| 1598008989 | Katherine Malczewski | Obstetrics & Gynecology | 301 Fisher St, Biloxi, MS 39534-2508 | 2013-04-03 |
| 1609129808 | Donna E Alexander Md Obstetrics and Gynecology LLC | Obstetrics & Gynecology | 1721 Medical Park Dr, Suite 100, Biloxi, MS 39532-2109 | 2012-10-25 |
| 1730435439 | Biloxi Hma Physician Management, LLC | Obstetrics & Gynecology | 147 Reynoir St, Suite 203, Biloxi, MS 39530-4109 | 2012-07-31 |
| 1114180528 | Joy E Wheat | Obstetrics & Gynecology | 301 Fisher St, Keesler Afb Women's Health Clinic, Biloxi, MS 39534-2508 | 2008-07-07 |
| 1487814745 | Tonya Henderson | Obstetrics & Gynecology | 301 Fisher St, Biloxi, MS 39534-2508 | 2008-06-11 |
| 1124206784 | The Diaz Clinic, Pllc | Obstetrics & Gynecology | 1720a Medical Park Dr, Suite 130, Biloxi, MS 39532-2129 | 2008-02-06 |
| 1114127222 | Courtney Elizabeth Meredith | Obstetrics & Gynecology | 147 Reynoir St, Suite 105, Biloxi, MS 39530-4109 | 2007-07-18 |
| Find all providers in BILOXI | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.