Provider Demographics
NPI:1790817526
Name:MICHAEL C GOOD MD PLLC
Entity Type:Organization
Organization Name:MICHAEL C GOOD MD PLLC
Other - Org Name:NEW BUSINESS
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNERMEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:CLAY
Authorized Official - Last Name:GOOD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:931-461-9981
Mailing Address - Street 1:1321 MCARTHUR ST STE B
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:TN
Mailing Address - Zip Code:37355-2493
Mailing Address - Country:US
Mailing Address - Phone:931-461-9981
Mailing Address - Fax:931-461-9982
Practice Address - Street 1:1321 MCARTHUR ST STE B
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:TN
Practice Address - Zip Code:37355-2493
Practice Address - Country:US
Practice Address - Phone:931-461-9981
Practice Address - Fax:931-461-9982
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2012-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD20246207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty