Goodrich, Jacob Allan

Goodrich, Jacob Allan is an individual health care provider with primary practice located at 1706 Magnolia Way , Augusta GA 30909-9481. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Orthopaedic Surgery, Allopathic & Osteopathic Physicians / Orthopaedic Surgery of the Spine. Allopathic & Osteopathic Physicians / Orthopaedic Surgery of the Spine is his primary health care specialty. Goodrich, Jacob Allan can be contacted via phone (706) 210-7529.

Contact Information

Primary practice address
1706 Magnolia Way Augusta GA 30909-9481
Phone: (706) 210-7529
Fax: (706) 312-7609
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 34112 South Carolina
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 020540 Georgia
Allopathic & Osteopathic Physicians / Orthopaedic Surgery of the Spine 207XS0117X 34112 South Carolina
Allopathic & Osteopathic Physicians / Orthopaedic Surgery of the Spine 207XS0117X 34412 South Carolina
Allopathic & Osteopathic Physicians / Orthopaedic Surgery of the Spine 207XS0117X 020540 Georgia

Profile Details

NPI number 1700847399
LBN Legal business name Goodrich, Jacob Allan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 31st, 2006
Last updated Apr 3rd, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1700847399 NPPES
Georgia MEDICAID REF000028280
Georgia MEDICAID 000239357F
Georgia MEDICAID G20540

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