| Dr Wallace Hanna Good Jr, MD | |
|
12 Lakemount Dr, Saint Albans, VT 05478-0386 | |
| (802) 524-5867 | |
| Not Available |
| Full Name | Dr Wallace Hanna Good Jr |
|---|---|
| Gender | Male |
| Speciality | Anesthesiology |
| Location | 12 Lakemount Dr, Saint Albans, Vermont |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568496008 | NPI | - | NPPES |
| 06375 | Other | VT | BLUE SHIELD |
| 01053034 | Medicaid | NY | |
| 0006375 | Medicaid | VT | |
| 86095 | Other | VT | MVP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207L00000X | Anesthesiology | 042-0006834 (Vermont) | Primary |
| 207L00000X | Anesthesiology | 144954 (New York) | Secondary |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Wallace Hanna Good Jr, MD Po Box 386, Saint Albans, VT 05478-0386 Ph: (802) 452-5817 | Dr Wallace Hanna Good Jr, MD 12 Lakemount Dr, Saint Albans, VT 05478-0386 Ph: (802) 524-5867 |
Tal O. Leyshon, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 8 Lake Mont Dr, Saint Albans, VT 05478 Phone: 734-255-0409 | |
Thomas Harrison I, Anesthesiology Medicare: May Accept Medicare Assignments Practice Location: 133 Fairfield St, Saint Albans, VT 05478 Phone: 802-524-7100 |