Provider Demographics
NPI:1922971043
Name:GOODPASTER, WILLIAM A III
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:A
Last Name:GOODPASTER
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 STOKESAY ST APT 2
Mailing Address - Street 2:
Mailing Address - City:LUDLOW
Mailing Address - State:KY
Mailing Address - Zip Code:41016-1358
Mailing Address - Country:US
Mailing Address - Phone:859-878-4981
Mailing Address - Fax:
Practice Address - Street 1:2001 MADISON AVE
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:KY
Practice Address - Zip Code:41014-1209
Practice Address - Country:US
Practice Address - Phone:859-444-4499
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-25
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist