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:
Health care specialties
| Specialty | Code | License # | 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 18 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| 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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