Jerry L Goddard, MD
Jerry L Goddard, MD is a Family Practice in Carbondale, Illinois. Graduated from Tulane University School of Medicine in 1970, 56 years ago. Practices with Board of Trustees of Southern Illinois University, a 142-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Illinois.
- Years since qualifying
- 56
- Trained at
- Tulane University School of Medicine
- Licensed in
- IL
- In the registry since
- 2005
- Specialties on file
- 2
What do these letters mean?
- MD — Doctor of Medicine
- A physician who completed allopathic medical school.
Practice location Address checks out
305 W Jackson St Ste 200Carbondale, IL 62901-1474
Phone: (618) 536-6621
Fax: (618) 453-1102
Show map & directions
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Additional practice locations (1)
- 2553 Ken Gray Blvd, West Frankfort, IL 62896-4174 — (618) 932-3937
Specialties & licences
| Family Medicine Physician (primary) | Taxonomy 207Q00000X · Licence 036-054846 (IL) |
|---|---|
| Sports Medicine (Family Medicine) Physician | Taxonomy 207QS0010X · Licence 036-054846 (IL) |
Record details
| NPI number | 1295711240 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | MD |
| Sole proprietor | No |
| NPI enumerated | December 21, 2005 |
| Last updated in NPPES | December 28, 2020 |
| Certification date | December 28, 2020 |
| Mailing address | 305 W Jackson St, Ste 200, Carbondale, IL 62901-1474 |
Medicare enrollment
| Medicare specialty | FAMILY PRACTICE |
|---|---|
| Medical school | TULANE UNIVERSITY SCHOOL OF MEDICINE |
| Graduated | 1970 (56 years in practice) |
| Group practice | Board Of Trustees Of Southern Illinois University — 142 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
| Practice locations | 2 on file with Medicare |
Other providers in Carbondale
-
Dr. Richard Efem, MD
300 W Oak St, Carbondale, IL 62901-1400 · (618) 536-6621
-
Jon O Humphrey, MD
305 W Jackson St Ste 200, Carbondale, IL 62901-1474 · (618) 453-3777
-
Kevin Izquierdo
300 W Oak St Ste 200, Carbondale, IL 62901-1400 · (618) 536-6621
-
Scott K Schonewolf, MD
305 W Jackson St Ste 200, Carbondale, IL 62901 · (618) 453-3777