Healthcare Provider Details

I. General information

NPI: 1992628788
Provider Name (Legal Business Name): WANDA GOOD DO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9399 CROWN CREST BLVD STE 240
PARKER CO
80138-8571
US

IV. Provider business mailing address

9399 CROWN CREST BLVD STE 240
PARKER CO
80138-8571
US

V. Phone/Fax

Practice location:
  • Phone: 720-465-1173
  • Fax:
Mailing address:
  • Phone: 720-465-1173
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: WANDA GOOD
Title or Position: PHYSICIAN/OWNER
Credential: DO
Phone: 303-817-7773