NPI 1194734749

Michael Steven Godat, PAC

Practitioner Physician Assistant Fort Leonard Wood, MO

Practice location

Address: 126 Missouri Ave McXp-Ccs-Cr, Fort Leonard Wood, MO 65473-8952
Phone: (573) 596-0417
Fax: (573) 596-0524

Registered specialties

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence 2005037319 (MO)

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Registry record

NPI: 1194734749
Entity type: Individual
Sex (as registered): Male
NPI issued: 5 Aug 2006
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.