MEDICARE: DR. JACQUELINE GOODRICH MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program	112573	GA

General Provider Information

NPI Number	:	1295671923
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JACQUELINE GOODRICH MD

Provider Business Mailing Address
First Line	:	677 CHURCH STREET
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30060
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	677 CHURCH STREET
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30060
Country	:	US
Telephone Number	:	470-793-6148
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/27/2026
Last Update Date	:	04/27/2026

Similar Medicare Providers

1831892686 — SYDNEY ALLISON JAMES
Practice Location Address:

677 CHURCH ST NE
MARIETTA, GA
30060-1101

Practice Phone: 662-352-9571
Practice Fax:

1477012243 — MANUEL COUTINHO
Practice Location Address:

121 MARBLE MILL RD NW
MARIETTA, GA
30060-7959

Practice Phone: 770-422-8315
Practice Fax: 770-590-9170

1871439141 — SELINA ABUNDEZ
Practice Location Address:

210 COBB PKWY S
MARIETTA, GA
30060-6509

Practice Phone: 770-429-9096
Practice Fax:

1629802210 — REKETA ROJAS LPC
Practice Location Address:

840 ROSWELL ST SE
MARIETTA, GA
30060-2182

Practice Phone: 678-383-4142
Practice Fax:

1811876048 — PATRICK MICHAEL TROMAN PA-C
Practice Location Address:

55 WHITCHER ST NE STE 350
MARIETTA, GA
30060-1129

Practice Phone: 770-424-6893
Practice Fax:

1508129883 — FRANK YUAN M.D.
Practice Location Address:

55 WHITCHER ST NE STE 450
MARIETTA, GA
30060-1171

Practice Phone: 770-800-1882
Practice Fax:

Directions to “ DR. JACQUELINE GOODRICH MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.