Basic Information
Provider Information
NPI: 1104060185
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GOODSON
FirstName: WILLIAM
MiddleName: HOUSTON
NamePrefix: DR.
NameSuffix: JR.
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4040 MEMORIAL PKWY SW
Address2:  
City: HUNTSVILLE
State: AL
PostalCode: 358024364
CountryCode: US
TelephoneNumber: 2565331970
FaxNumber: 2567056479
Practice Location
Address1: 4040 MEMORIAL PKWY SW
Address2:  
City: HUNTSVILLE
State: AL
PostalCode: 358024364
CountryCode: US
TelephoneNumber: 2565331970
FaxNumber: 2567056479
Other Information
ProviderEnumerationDate: 04/22/2009
LastUpdateDate: 04/22/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0800X3603ALY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry

No ID Information.


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