Healthcare Provider Details

I. General information

NPI: 1144313131
Provider Name (Legal Business Name): JAMES W GOODNIGHT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 10/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

535 HIGH MOUNTAIN RD SUITE110
NORTH HALEDON NJ
07508-2665
US

IV. Provider business mailing address

535 HIGH MOUNTAIN RD SUITE110
NORTH HALEDON NJ
07508-2665
US

V. Phone/Fax

Practice location:
  • Phone: 973-427-2711
  • Fax: 973-427-2770
Mailing address:
  • Phone: 973-427-2711
  • Fax: 973-427-2770

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number25MA06252500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: