Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 15959 | WV |
N | 207YP0228X | Pediatric Otolaryngology | 15959 | WV |
Y | 207YP0228X | Pediatric Otolaryngology | 35.063446 | OH |
N | 207YP0228X | Pediatric Otolaryngology | ME108726 | FL |
NPI | 1588602528 |
---|---|
Provider Name | Terry L Good |
First Address | Akron, OH 44308-1063 |
Second Address | Akron, OH 44308-1063 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2006 |
Last Update Date | 02/05/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
003040100 | (05) | FL |
E76011 | (02) |