Provider Demographics
NPI:1730464777
Name:GODBEY, MARTHA JEAN
Entity Type:Individual
Prefix:DR
First Name:MARTHA
Middle Name:JEAN
Last Name:GODBEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JEANIE
Other - Middle Name:
Other - Last Name:GODBEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2721 JIM HOUSTON CT
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-5146
Mailing Address - Country:US
Mailing Address - Phone:615-631-8423
Mailing Address - Fax:
Practice Address - Street 1:2006 MEDICAL CENTER PKWY
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129
Practice Address - Country:US
Practice Address - Phone:615-896-2768
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-20
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN33104183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist