Healthcare Provider Details

I. General information

NPI: 1851209878
Provider Name (Legal Business Name): THE GOOD CLINIC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2387 MAIN ST
WILLISBURG KY
40078-8102
US

IV. Provider business mailing address

2387 MAIN ST
WILLISBURG KY
40078-8102
US

V. Phone/Fax

Practice location:
  • Phone: 859-459-5002
  • Fax: 859-459-5003
Mailing address:
  • Phone: 859-459-5002
  • Fax: 859-459-5003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. ROBERT WAYNE GOODLETT
Title or Position: OWNER
Credential: MD
Phone: 859-481-8098