Healthcare Provider Details

I. General information

NPI: 1942316682
Provider Name (Legal Business Name): DANIEL JOHN GOOD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2006
Last Update Date: 07/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5419 N LOVINGTON HWY LEA REGIONAL MEDICAL CENTER
HOBBS NM
88240
US

IV. Provider business mailing address

5419 N LOVINGTON HWY SUITE 22
HOBBS NM
88240-9100
US

V. Phone/Fax

Practice location:
  • Phone: 575-492-5000
  • Fax:
Mailing address:
  • Phone: 806-470-5400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberJ8554
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberA064629
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberE2486
License Number StateAR
# 4
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number42264
License Number StateTN
# 5
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMD2014-0535
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: