Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 28515 | AZ |
Y | 207XS0106X | Orthopaedic Hand Surgeon | 28515 | AZ |
N | 2086S0105X | Surgery of the Hand | 28515 | AZ |
NPI | 1033110762 |
---|---|
Provider Name | Joel R Goode |
First Address | Tucson, AZ 85751-1630 |
Second Address | Tucson, AZ 85712-2805 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2005 |
Last Update Date | 23/02/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
519712 | (05) | AZ |
H24258 | (02) | AZ |