Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | PD-000950 | AZ |
Y | 222Z00000X | Podiatrist | PD-000950 | AZ |
NPI | 1013261684 |
---|---|
Provider Name | Dr. Andrew Goodeill |
First Address | Gilbert, AZ 85234-2969 |
Second Address | Gilbert, AZ 85234-2969 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/11/2012 |
Last Update Date | 25/08/2020 |