Provider Demographics
NPI:1215075403
Name:GOODMAN, WILLIAM W III (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:W
Last Name:GOODMAN
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 802843
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64180-2843
Mailing Address - Country:US
Mailing Address - Phone:417-730-6430
Mailing Address - Fax:417-269-7567
Practice Address - Street 1:1000 E HIGHWAY 60
Practice Address - Street 2:
Practice Address - City:MONETT
Practice Address - State:MO
Practice Address - Zip Code:65708-8258
Practice Address - Country:US
Practice Address - Phone:417-236-2440
Practice Address - Fax:417-354-1458
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2021-11-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2001001469207XP3100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO205197205Medicaid
MOG22539Medicare UPIN
MO361013268Medicare PIN