Provider Demographics
NPI:1710050760
Name:GOOD, RICHARD C (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:C
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 1:3240 MOUNT MORIAH AVE
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42303-7805
Mailing Address - Country:US
Mailing Address - Phone:270-926-4449
Mailing Address - Fax:270-926-4554
Practice Address - Street 1:3240 MOUNT MORIAH AVE
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-7805
Practice Address - Country:US
Practice Address - Phone:270-926-4449
Practice Address - Fax:270-926-4554
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY38081207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300061176Medicaid
KY38081OtherSTATE LICENSE
KY64066178Medicaid
KY000000340420OtherBCBS
KY000000340420OtherBCBS
KY64066178Medicaid
KY000000340420OtherBCBS
KYG98285Medicare UPIN