Provider Demographics
NPI:1306828157
Name:GOODNIGHT, JAMES EDGAR JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:EDGAR
Last Name:GOODNIGHT
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:2315 STOCKTON BLVD
Mailing Address - Street 2:DEPARTMENT OF SURGERY
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817-2201
Mailing Address - Country:US
Mailing Address - Phone:916-734-3190
Mailing Address - Fax:916-734-5119
Practice Address - Street 1:2315 STOCKTON BLVD
Practice Address - Street 2:DEPARTMENT OF SURGERY
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-2201
Practice Address - Country:US
Practice Address - Phone:916-734-3190
Practice Address - Fax:916-734-5119
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-17
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
CAC3706202086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA36473Medicare UPIN