Provider Demographics
NPI:1578629275
Name:MYRTLE E GOORE, MD
Entity type:Organization
Organization Name:MYRTLE E GOORE, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MYRTLE
Authorized Official - Middle Name:E
Authorized Official - Last Name:GOORE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:334-244-1161
Mailing Address - Street 1:2257 TAYLOR RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-7790
Mailing Address - Country:US
Mailing Address - Phone:334-270-9914
Mailing Address - Fax:334-270-3195
Practice Address - Street 1:7209 COPPERFIELD DR
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-7101
Practice Address - Country:US
Practice Address - Phone:334-244-1161
Practice Address - Fax:334-244-8772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty