Healthcare Provider Details

I. General information

NPI: 1053816959
Provider Name (Legal Business Name): COLIN L GOOD DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2018
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 W CHERRY ST
SUNBURY OH
43074-3575
US

IV. Provider business mailing address

700 ACKERMAN RD STE 2120
COLUMBUS OH
43202-1559
US

V. Phone/Fax

Practice location:
  • Phone: 614-685-2805
  • Fax: 614-366-3562
Mailing address:
  • Phone: 614-685-2805
  • Fax: 614-366-3562

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number34.016900
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: