Provider Demographics
NPI:1457811317
Name:GOOD, ALLISON JEAN (MD)
Entity type:Individual
Prefix:MS
First Name:ALLISON
Middle Name:JEAN
Last Name:GOOD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13575 NW 1ST LN STE 10
Mailing Address - Street 2:
Mailing Address - City:NEWBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32669-3735
Mailing Address - Country:US
Mailing Address - Phone:833-928-0867
Mailing Address - Fax:
Practice Address - Street 1:13575 NW 1ST LN STE 10
Practice Address - Street 2:
Practice Address - City:NEWBERRY
Practice Address - State:FL
Practice Address - Zip Code:32669-3735
Practice Address - Country:US
Practice Address - Phone:833-928-0867
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-25
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLME160686207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program