Individual
DR. JACOB ALLAN GOODRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
211 HIGH GATE LOOP, AIKEN, SC 29803-3921
(803) 265-8117
(803) 265-2502
Mailing address
1706 MAGNOLIA WAY, AUGUSTA, GA 30909-9481
(706) 210-7529
(706) 312-7609
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
020540
GA
207X00000X
Orthopaedic Surgery Physician
34112
SC
207XS0117X
Orthopaedic Surgery of the Spine Physician
020540
GA
207XS0117X
Orthopaedic Surgery of the Spine Physician
34112
SC
207XS0117X
Orthopaedic Surgery of the Spine Physician
34412
SC
Other
Enumeration date
03/31/2006
Last updated
09/25/2024
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