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Organization
AZ CORRIDOR EMERGENCY PHYSICIANS
Active
Organization
AZ CORRIDOR EMERGENCY PHYSICIANS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DONALD T GODBOLD MD (GENERAL PARTNER)
(805) 563-3011
Entity
Organization
Contact information
Practice address
1800 E FLORENCE BLVD, CASA GRANDE, AZ 85222-5303
(520) 381-6300
Mailing address
3916 STATE ST, #300, SANTA BARBARA, CA 93105-5602
(805) 563-3011
(805) 563-3011
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
224499
—
AZ
01
—
DG3676
RAILROAD MEDICARE
AZ
Enumeration date
05/12/2007
Last updated
01/28/2010
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