Basic Information
| Provider Information | |||||||||
| NPI: | 1578764205 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GOODROAD | ||||||||
| FirstName: | SCOTT | ||||||||
| MiddleName: | DAVID | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | CARL R. DARNALL ARMY MEDICAL CENTER | ||||||||
| Address2: | 36000 DARNALL LOOP | ||||||||
| City: | FORT HOOD | ||||||||
| State: | TX | ||||||||
| PostalCode: | 76544 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2546188790 | ||||||||
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| Practice Location | |||||||||
| Address1: | CARL R. DARNALL ARMY MEDICAL CENTER | ||||||||
| Address2: | 36000 DARNALL LOOP | ||||||||
| City: | FORT HOOD | ||||||||
| State: | TX | ||||||||
| PostalCode: | 76544 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2542888303 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/30/2007 | ||||||||
| LastUpdateDate: | 11/04/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | N5690 | TX | Y | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | 0102202169 | VA | N | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.