Provider Demographics
NPI:1871476192
Name:GOODMAN, CASEE WYNDHAM
Entity type:Individual
Prefix:
First Name:CASEE
Middle Name:WYNDHAM
Last Name:GOODMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 GRADY AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:POTEAU
Mailing Address - State:OK
Mailing Address - Zip Code:74953-4310
Mailing Address - Country:US
Mailing Address - Phone:918-721-5680
Mailing Address - Fax:
Practice Address - Street 1:208 GRADY AVE APT 3
Practice Address - Street 2:
Practice Address - City:POTEAU
Practice Address - State:OK
Practice Address - Zip Code:74953-4310
Practice Address - Country:US
Practice Address - Phone:918-721-5680
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-26
Last Update Date:2025-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker