MRS. DEBORA ANN GOODRICH (NPI# 1245325968) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245325968 |
| Entity Type | Individual |
| Full Name | MRS. DEBORA ANN GOODRICH |
| Credential | DO |
| Practice Address |
1301 Well Brook Circle Conyers GA 30012-3873 |
| Practice Telephone | 7709223023 |
| Practice Fax Number | 7709291016 |
| Mailing Telephone | 7709223023 |
| Mailing Fax Number | 7709291016 |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2010-02-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 041125 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 00691094A | 05 |
| Street Address |
1301 WELL BROOK CIRCLE |
| City | CONYERS |
| State | GA |
| Zip Code | 30012-3873 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457446171 | James Ransford De Give | Internal Medicine | 1301 Well Brook Circle, Conyers, GA 30012-3873 | 2006-10-04 |
| 1588759211 | Jason Dale Anderson | Internal Medicine | 1301 Well Brook Circle, Conyers, GA 30012-3873 | 2006-10-04 |
| 1033204748 | Marshall David Almand | Internal Medicine | 1301 Well Brook Circle, Conyers, GA 30012-3873 | 2006-10-04 |
| 1104911817 | Taiwanna Granae Brown-bolds | Internal Medicine | 1301 Well Brook Circle, Conyers, GA 30012-3873 | 2006-10-04 |
| 1619062338 | Elizabeth Dykes Degive | Internal Medicine | 1301 Well Brook Circle, Conyers, GA 30012-3873 | 2006-10-04 |
| 1336234053 | John Manor Entrekin | Internal Medicine | 1301 Well Brook Circle, Conyers, GA 30012-3873 | 2006-10-04 |
| 1407941131 | Jack Lee Sorg | General Practice | 1301 Well Brook Circle, Conyers, GA 30012-3873 | 2006-10-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578188306 | The Eye Md | Ophthalmology | 1359 Milstead Road, Suite #103, Conyers, GA 30012 | 2020-06-08 |
| 1043855836 | Maurvet Minto | Counselor | 1175 Green St, Conyers, Conyers, GA 30012 | 2019-11-15 |
| 1770054561 | Sarah Elizabeth Brooks | Physical Medicine & Rehabilitation | 1290 Milstead Ave Ne, Conyers, GA 30012 | 2018-12-06 |
| 1679091276 | Valorie Antoinette Jones | Counselor | 1175 Green St Se, Conyers, GA 30012 | 2017-09-02 |
| 1558886341 | Synergy Radiology, LLC | Radiology | 1501 Milstead Road, Suite 140, Conyers, GA 30012 | 2017-08-14 |
| 1558813295 | Salon Lyon, LLC | Specialist | 1112 West Ave, Se, B, Conyers, GA 30012 | 2016-10-28 |
| 1992252753 | Traci Hunter Bryan | Pharmacist | 1501 Milstead Ave Ne, Suite 110, Conyers, GA 30012 | 2016-09-08 |
| 1316491830 | Hye Rim Kim | Anesthesiologist Assistant | 1380 Milstead Rd Ne, Suite G, Conyers, GA 30012 | 2016-08-12 |
| 1235591397 | David Jeffrey Wasserman | Optometrist | 1192 Dogwood Dr Sw, Conyers, GA 30012 | 2016-03-28 |
| 1174919187 | Anique Archer | Health Educator | 2170 Lester Rd Nw, Conyers, GA 30012 | 2015-04-07 |
| Find all providers in zip 30012 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528358280 | Camille Patrice Mclean | Internal Medicine | 2347 New Haven Pl, Conyers, GA 30094-3358 | 2011-04-14 |
| 1508186867 | Craig O'neil Campbell | Internal Medicine | 1525 Paceville Ct, Conyers, GA 30012-7125 | 2010-06-09 |
| 1982832739 | Gregory E. Jones | Internal Medicine | 1415 Milstead Ave Ne, Conyers, GA 30012 | 2009-06-30 |
| 1982845665 | Samuel Davis Mintlow | Internal Medicine | 3241 Lindas Cir Se, Conyers, GA 30013-2238 | 2009-03-10 |
| 1689730244 | Bassam Tome | Internal Medicine | 1277 Wellbrook Cir Ne, Suite C, Conyers, GA 30012-3873 | 2006-12-28 |
| 1437211703 | Eastside Internal Medicine, LLC | Internal Medicine | 2080 Eastside Dr, Suite A, Conyers, GA 30013-1953 | 2006-12-14 |
| 1457446189 | Mary Harris Stephens | Internal Medicine | 1301 Wellbrook Circle, Conyers, GA 30012-3873 | 2006-10-04 |
| 1457446171 | James Ransford De Give | Internal Medicine | 1301 Well Brook Circle, Conyers, GA 30012-3873 | 2006-10-04 |
| 1215028253 | Harmon Andrew Smith | Internal Medicine | 1080 Green St Sw, Conyers, GA 30012-5269 | 2006-09-27 |
| 1386735066 | East Metro Internal Medicine | Internal Medicine | 3641 Highway 20 Se, Suite A, Conyers, GA 30013-3064 | 2006-09-27 |
| Find all providers in CONYERS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.