MEDICARE: TAYLOR K GOODNOUGH DO

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	207QG0300X	Geriatric Medicine (Family Medicine) Physician	OS013113	PA
2	207QH0002X	Hospice and Palliative Medicine (Family Medicine) Physician	2008-01879	NC
3	207QG0300X	Geriatric Medicine (Family Medicine) Physician	2008-01879	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598745325
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAYLOR K GOODNOUGH DO

Provider Business Mailing Address
First Line	:	2402 WAYNE MEMORIAL DR
Second Line	:
City	:	GOLDSBORO
State	:	NC
Zip	:	27534-1728
Country	:	US
Telephone Number	:	919-735-1387
Fax Number	:	910-853-6022

Provider Business Practice Location Address
First Line	:	5306 NC HIGHWAY 55 STE 105
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27713-7812
Country	:	US
Telephone Number	:	919-646-4858
Fax Number	:	919-679-7112

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

Provider Enumeration Date	:	01/18/2006
Last Update Date	:	04/10/2025

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Directions to “ TAYLOR K GOODNOUGH DO” Practice Location

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