Provider Demographics
NPI:1689677155
Name:GOODSON, JAMES A III (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:A
Last Name:GOODSON
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:367 WEST EVANS STREET
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-3429
Mailing Address - Country:US
Mailing Address - Phone:843-669-4156
Mailing Address - Fax:843-664-2121
Practice Address - Street 1:365 W WESMARK BLVD
Practice Address - Street 2:
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29150-1987
Practice Address - Country:US
Practice Address - Phone:803-905-8020
Practice Address - Fax:803-905-8025
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2024-02-14
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Provider Licenses
StateLicense IDTaxonomies
SC19334207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCS327577OtherCIGNA
SC9624212OtherGHI
SC180039403OtherRAILROAD MEDICARE
SC20036069OtherSELECT HEALTH
SC9060247OtherPRIVATE HEALTHCARE SYSTEM
SCT36128Medicaid
SC5418708OtherAETNA
SC5418708OtherAETNA