Provider Demographics
NPI:1821257304
Name:GOODRICH, JAROD (DO)
Entity Type:Individual
Prefix:DR
First Name:JAROD
Middle Name:
Last Name:GOODRICH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:182 TRANKILO ST
Mailing Address - Street 2:APT 801
Mailing Address - City:TAMUNING
Mailing Address - State:GU
Mailing Address - Zip Code:96913-3433
Mailing Address - Country:US
Mailing Address - Phone:671-489-8914
Mailing Address - Fax:
Practice Address - Street 1:GUAM REGIONAL MEDICAL CITY
Practice Address - Street 2:133 ROUTE 3
Practice Address - City:DEDEDO
Practice Address - State:GU
Practice Address - Zip Code:96929
Practice Address - Country:US
Practice Address - Phone:671-489-8914
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-09
Last Update Date:2016-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102202606207X00000X
GUDO-0065207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery