Provider Demographics
NPI:1891745782
Name:GODSIL, RAYMOND D JR (MD)
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:D
Last Name:GODSIL
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:121 NORTH 20TH ST #18
Mailing Address - Street 2:THE ORTHOPAEDIC CLINIC P.C.
Mailing Address - City:OPELIKA
Mailing Address - State:AL
Mailing Address - Zip Code:36801
Mailing Address - Country:US
Mailing Address - Phone:334-749-8303
Mailing Address - Fax:334-745-5243
Practice Address - Street 1:121 NORTH 20TH ST #18
Practice Address - Street 2:THE ORTHOPAEDIC CLINIC P.C.
Practice Address - City:OPELIKA
Practice Address - State:AL
Practice Address - Zip Code:36801
Practice Address - Country:US
Practice Address - Phone:334-749-8303
Practice Address - Fax:334-745-5243
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2013-10-09
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Provider Licenses
StateLicense IDTaxonomies
AL5629207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000082830Medicaid
AL200011391OtherRRMC
AL0449560001OtherPGA DURABLE
AL510-82830OtherBCBS AL
AL510-82830OtherBCBS AL
AL000082830Medicaid