Provider Demographics
NPI:1265543854
Name:GOODHUE, ERIN KATHLEEN (DO)
Entity type:Individual
Prefix:DR
First Name:ERIN
Middle Name:KATHLEEN
Last Name:GOODHUE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:ERIN
Other - Middle Name:KATHLEEN
Other - Last Name:MEYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:700 ACKERMAN RD STE 2120
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1559
Mailing Address - Country:US
Mailing Address - Phone:614-293-5905
Mailing Address - Fax:614-293-4715
Practice Address - Street 1:410 W 10TH AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43210-1240
Practice Address - Country:US
Practice Address - Phone:614-293-5905
Practice Address - Fax:614-293-4715
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34012070207ZH0000X, 207ZP0102X, 207ZB0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZH0000XAllopathic & Osteopathic PhysiciansPathologyHematology
No207ZB0001XAllopathic & Osteopathic PhysiciansPathologyBlood Banking & Transfusion Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0152032Medicaid