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NPI 1225073281

NPI 1225073281 : ROBERT L GOOD MD : LEOLA, PA

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General NPI Number Information
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    NPI Number           |    1225073281
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    Entity Type          |    Individual 
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    Provider Name        |    ROBERT L GOOD MD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    06/16/2006
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    Last Update Date     |    05/27/2015
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Provider Practice Location Address
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    Address Line         |    337 W MAIN ST 
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    City                 |    LEOLA
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    State                |    PA
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    Zip                  |    17540-2109
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    Country              |    US
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    Telephone            |    717-656-6122
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    Fax                  |    717-656-0142
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Provider Business Mailing Address
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    Address Line         |    4131 OREGON PIKE SUITE C
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    City                 |    EPHRATA
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    State                |    PA
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    Zip                  |    17522-9550
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    Country              |    US
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    Telephone            |    717-859-5161
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    Fax                  |    717-859-5169
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207Q00000X
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    Taxonomy Name        |    Family Medicine Physician
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    License Number       |    MD036150E
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    License Number State |    PA
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