DR. ROBERT CARROLL GOODMAN JR. (NPI# 1689727398) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689727398 |
| Entity Type | Individual |
| Full Name | DR. ROBERT CARROLL GOODMAN JR. |
| Credential | PHARMD., BCPS |
| Practice Address |
908 Wallace Ave Suite 105, Midway Pharmacy Leitchfield KY 42754-1479 |
| Practice Telephone | 2702598400 |
| Practice Fax Number | 2702308517 |
| Mailing Telephone | 2702598400 |
| Mailing Fax Number | 2702308517 |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 009475 | KY | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | PHARMACIST LICENSE | 009475 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821596909 | Robert Leland Goodman | Counselor | 1134 W. North Ave, Second Floor, Milwaukee, WI 53205 | 2018-01-24 |
| 1003079203 | Robert H Goodman | Specialist | 124 Lafayette Dr Ne Apt 4, Atlanta, GA 30309-3344 | 2008-07-08 |
| 1508998089 | Robert M Goodman | Emergency Medicine | 21751 Chase Dr, Novi, MI 48375-4767 | 2007-03-11 |
| 1831276492 | Robert William Goodman | Dentist | 42430 West Twelve Mile Road, Suite 101, Novi, MI 48377-3028 | 2006-11-01 |
| 1487754156 | Robert L. Goodman | Surgery | 66 Morgan Rd, West Springfield, MA 01089-1410 | 2006-09-23 |
| 1982639373 | Robert Lehr Goodman | Internal Medicine | 2532 Grand Concourse, Bronx, NY 10458-4902 | 2006-07-12 |
| 1588698468 | Robert C Goodman | Podiatrist | 10 Colonial Rd Ste 8, Colonial Office Park, Salem, MA 01970-2947 | 2006-07-10 |
| 1982666855 | Robert Lee Goodman | Family Medicine | 1331 Medical Center Dr, Suite C, Rohnert Park, CA 94928-2900 | 2006-04-05 |
| 1982674131 | Robert C. Goodman | Social Worker | 3929 Tinsley Dr Ste 104, High Point, NC 27265-1531 | 2006-01-23 |
| 1851370787 | Robert George Goodman | Psychologist | 83 Franklin St, Watertown, MA 02472-4020 | 2006-01-10 |
| Street Address |
908 WALLACE AVE SUITE 105, MIDWAY PHARMACY |
| City | LEITCHFIELD |
| State | KY |
| Zip Code | 42754-1479 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336142025 | Ted B Rogers | Orthopaedic Surgery | 908 Wallace Ave, Leitchfield, KY 42754 | 2005-05-27 |
| 1598311045 | Ashley Nicole Flener | Nurse Practitioner | 908 Wallace Ave, Leitchfield, KY 42754-1479 | 2019-08-12 |
| 1700307451 | Jennifer Hughes | Nurse Practitioner | 908 Wallace Ave, Leitchfield, KY 42754-1479 | 2017-07-03 |
| 1578971800 | Bryce A. Meredith | Family Medicine | 908 Wallace Ave, Leitchfield, KY 42754-1479 | 2014-07-30 |
| 1366869208 | Elizabeth S Stivers | Pediatrics | 908 Wallace Ave, Suite 108, Leitchfield, KY 42754-1479 | 2014-03-27 |
| 1134488539 | Isaac David Miller | Family Medicine | 908 Wallace Ave, Leitchfield, KY 42754-1479 | 2012-05-07 |
| 1255526307 | Tony W Lee Do Medical Offices, Pllc | Internal Medicine | 908 Wallace Ave, Suite 203, Leitchfield, KY 42754-1479 | 2007-09-12 |
| 1518042886 | Shagufta Yousaf | Pediatrics | 908 Wallace Ave, Ste 108, Leitchfield, KY 42754 | 2006-10-26 |
| 1205870862 | Twin Lakes Medical Foundation Inc | Obstetrics & Gynecology | 908 Wallace Ave, Leitchfield, KY 42754-1479 | 2006-06-15 |
| 1982682878 | Trevor Vance Ray | Pharmacist | 908 Wallace Ave, Suite 105, Leitchfield, KY 42754-1479 | 2006-01-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750816849 | April Braun | Occupational Therapy Assistant | 121 Byrtle Grove Rd, Leitchfield, KY 42754 | 2017-04-26 |
| 1124429766 | Scott Anthony Gibson | Counselor | 805 Commerce Dr, Leitchfield, KY 42754 | 2014-09-15 |
| 1013328137 | Sandra M Dennis | Counselor | 505 O Riley St, Leitchfield, KY 42754 | 2014-05-12 |
| 1699071258 | Ellen Renae Pharis | Massage Therapist | 205 Fraim St, Leitchfield, KY 42754 | 2011-01-31 |
| 1184664096 | Joseph Michael Harris Jr. | Physical Therapist | 201 South Main Street, Leitchfield, KY 42754 | 2006-06-08 |
| 1689611469 | Joseph Michael Mulligan | Nurse Anesthetist, Certified Registered | 515 Lake Front Rd., Leitchfield, KY 42754 | 2006-06-01 |
| 1407838030 | Lincoln Trail District Health Dept | Public Health or Welfare | 124 E White Oak St, Leitchfield, KY 42754 | 2005-11-18 |
| 1487646527 | Larry Brett Abney | Optometrist | 31 Bobby Bland Way, Leitchfield, KY 42754 | 2005-08-16 |
| 1891267290 | Kristen Russell | Nurse Practitioner | 910 Wallace Ave, Leitchfield, KY 42754 | 2018-12-23 |
| 1912486887 | Jeanette Marie Jacobs | Pediatrics | 901 Wallace Ave, Leitchfield, KY 42754 | 2018-08-10 |
| Find all providers in zip 42754 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356816763 | Jon B Harned | Pharmacist | 406 Grayson St, Leitchfield, KY 42754-2238 | 2018-10-11 |
| 1740779446 | Jeremy Newton | Pharmacist | 908 Wallace Ave Ste 105, Leitchfield, KY 42754-1479 | 2018-05-08 |
| 1518567916 | Donald Ray Meers | Pharmacist | 1801 Elizabethtown Rd, Leitchfield, KY 42754-9138 | 2020-10-27 |
| 1659986412 | Reed Keehner Smith | Pharmacist | 311 N Main St, Leitchfield, KY 42754-2230 | 2020-09-09 |
| 1750826871 | Mckinzie Toler | Pharmacist | 515 S Main St, Leitchfield, KY 42754-1133 | 2016-12-28 |
| 1417331596 | Victoria Josephina Smith | Pharmacist | 311 N Main St, Leitchfield, KY 42754-2230 | 2015-07-17 |
| 1760897565 | Jonathan Shaw | Pharmacist | 515 S Main St, Leitchfield, KY 42754-1133 | 2014-07-01 |
| 1790117026 | Angela Mae Gibson | Pharmacist | 311 N Main St, Leitchfield, KY 42754-2230 | 2013-08-09 |
| 1245509363 | Donald R Anderson | Pharmacist | 311 N Main St, Leitchfield, KY 42754-2214 | 2011-12-19 |
| 1760772529 | David Franklin Tabor | Pharmacist | 515 S Main St, Leitchfield, KY 42754-1133 | 2011-04-13 |
| Find all providers in LEITCHFIELD | ||||
| City | LEITCHFIELD |
| Zip Code | 42754 |
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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.