Basic Information
| Provider Information | |||||||||
| NPI: | 1942316682 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GOOD | ||||||||
| FirstName: | DANIEL | ||||||||
| MiddleName: | JOHN | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5419 N LOVINGTON HWY | ||||||||
| Address2: | SUITE 22 | ||||||||
| City: | HOBBS | ||||||||
| State: | NM | ||||||||
| PostalCode: | 882409100 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8064705400 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5419 N LOVINGTON HWY | ||||||||
| Address2: | LEA REGIONAL MEDICAL CENTER | ||||||||
| City: | HOBBS | ||||||||
| State: | NM | ||||||||
| PostalCode: | 88240 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5754925000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/23/2006 | ||||||||
| LastUpdateDate: | 07/09/2014 | ||||||||
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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 | 207W00000X | J8554 | TX | N | Allopathic & Osteopathic Physicians | Ophthalmology | 207W00000X | A064629 | CA | N | Allopathic & Osteopathic Physicians | Ophthalmology | 207W00000X | E2486 | AR | N | Allopathic & Osteopathic Physicians | Ophthalmology | 207W00000X | 42264 | TN | N | Allopathic & Osteopathic Physicians | Ophthalmology | 207W00000X | MD2014-0535 | NM | Y | Allopathic & Osteopathic Physicians | Ophthalmology |
No ID Information.