Provider Demographics
NPI:1386987204
Name:GOOD, CHRISTOPHER SPENCER (PA)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:SPENCER
Last Name:GOOD
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:171 GERMAN HILL RD
Mailing Address - Street 2:
Mailing Address - City:TUNKHANNOCK
Mailing Address - State:PA
Mailing Address - Zip Code:18657-5747
Mailing Address - Country:US
Mailing Address - Phone:570-406-0503
Mailing Address - Fax:
Practice Address - Street 1:MARINERS HOSPITAL
Practice Address - Street 2:91500 OVERSEAS HIGHWAY
Practice Address - City:TAVERNIER
Practice Address - State:FL
Practice Address - Zip Code:33070
Practice Address - Country:US
Practice Address - Phone:305-434-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-28
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X
NMPA2019-0047363A00000X
MEPA1931363A00000X
PAMA002749L363A00000X
CA56858363A00000X
NC0010-11617363A00000X
FLPA9115219363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1386987204OtherNPI