Provider Demographics
NPI:1831283498
Name:GOOD, JOHN L (OD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:L
Last Name:GOOD
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:1022 WILLOW CREEK RD
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86301-1607
Mailing Address - Country:US
Mailing Address - Phone:284-451-3419
Mailing Address - Fax:928-778-3993
Practice Address - Street 1:1022 WILLOW CREEK RD
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86301-1607
Practice Address - Country:US
Practice Address - Phone:284-451-3419
Practice Address - Fax:928-778-3993
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2025-07-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NE1268152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist