Provider Demographics
NPI:1184866303
Name:GOOD, JASON ALAN (MD)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:ALAN
Last Name:GOOD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 6005
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46206-6005
Mailing Address - Country:US
Mailing Address - Phone:317-614-9850
Mailing Address - Fax:317-614-9655
Practice Address - Street 1:8040 CLEARVISTA PKWY
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46256-5630
Practice Address - Country:US
Practice Address - Phone:317-621-2000
Practice Address - Fax:317-614-9655
Is Sole Proprietor?:No
Enumeration Date:2009-04-02
Last Update Date:2013-04-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01070613A207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology