Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 29439 | IA |
NPI | 1033173430 |
---|---|
Provider Name | Dr. Devon Daniel Goetz |
First Address | West Des Moines, IA 50266-7702 |
Second Address | West Des Moines, IA 50266-7702 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2006 |
Last Update Date | 26/11/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F58468 | (02) |