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General NPI Number Information
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NPI Number | 1851698112
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Entity Type | Organization
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Legal Business Name | RICHMOND FAMILY MEDICINE PLLC
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Dates
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Enumeration Date | 02/23/2011
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Last Update Date | 09/05/2019
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Provider Practice Location Address
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Address Line | 30 W. MAIN ST.
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City | RICHMOND
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State | VT
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Zip | 05477
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Country | US
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Telephone | 802-434-4123
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Fax | 802-434-3130
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Provider Business Mailing Address
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Address Line | 30 W MAIN ST
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City | RICHMOND
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State | VT
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Zip | 05477-4479
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Country | US
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Telephone | 802-434-4123
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Fax | 802-434-3130
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Authorized Official
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Title or Position | MD/OWNER
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Name | DR. DANIEL MILLETT GOODYEAR
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Credential | M.D.
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Telephone | 802-578-8058
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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 |
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License Number State |
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