Provider Demographics
NPI:1801822192
Name:GODSEY, TROY WEBSTER (DC)
Entity Type:Individual
Prefix:DR
First Name:TROY
Middle Name:WEBSTER
Last Name:GODSEY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1919 E ATLANTIC BLVD
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33060-6551
Mailing Address - Country:US
Mailing Address - Phone:954-943-4900
Mailing Address - Fax:954-943-4931
Practice Address - Street 1:1919 E ATLANTIC BLVD
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33060-6551
Practice Address - Country:US
Practice Address - Phone:954-943-4900
Practice Address - Fax:954-943-4931
Is Sole Proprietor?:No
Enumeration Date:2006-06-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0007590111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL20-2281639OtherTIN
FL53899Medicare ID - Type Unspecified
FL20-2281639OtherTIN