Provider Demographics
NPI:1477089225
Name:GOOD, ALAN WILLIAM (MD)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:WILLIAM
Last Name:GOOD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1924 ALCOA HWY # U-11
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920-1511
Mailing Address - Country:US
Mailing Address - Phone:865-305-9230
Mailing Address - Fax:865-305-6958
Practice Address - Street 1:2521 GLENN HENDREN DR STE 108
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:MO
Practice Address - Zip Code:64068-3388
Practice Address - Country:US
Practice Address - Phone:816-781-3515
Practice Address - Fax:816-781-3517
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-11
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2022029107208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery