Provider Demographics
NPI:1013030782
Name:GOODWIN, WHITNEY (MD)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:
Last Name:GOODWIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9601 BAPTIST HEALTH DR
Mailing Address - Street 2:SUITE 1100
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-6321
Mailing Address - Country:US
Mailing Address - Phone:501-748-3214
Mailing Address - Fax:501-227-9151
Practice Address - Street 1:9601 BAPTIST HEALTH DR
Practice Address - Street 2:SUITE 1100
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-6321
Practice Address - Country:US
Practice Address - Phone:501-748-3214
Practice Address - Fax:501-227-9151
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE33792085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR164672001Medicaid
AR164672001Medicaid
ARP00429004OtherRAILROAD MEDICARE
AR5N885Medicare PIN