Good, Wallace Hanna

Good, Wallace Hanna is an sole proprietor health care provider with primary practice located at 12 Lakemount Dr , Saint Albans VT 05478-0386. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Good, Wallace Hanna can be contacted via phone (802) 524-5867.

Contact Information

Primary practice address
12 Lakemount Dr Saint Albans VT 05478-0386
Phone: (802) 524-5867
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 042-0006834 Vermont
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 144954 New York

Profile Details

NPI number 1568496008
LBN Legal business name Good, Wallace Hanna
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 10th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568496008 NPPES
Vermont Other 06375 BLUE SHIELD
Vermont MEDICAID 01053034 BLUE SHIELD
Vermont MEDICAID 0006375 BLUE SHIELD
Vermont Other 86095 BLUE SHIELD

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