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Organization
WHITE MOUNTAIN MEDICAL CONSULTANTS LLC
Active
Organization
WHITE MOUNTAIN MEDICAL CONSULTANTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN WILLIAM GOODMAN DO (TAX ID, PRACTICE OWNER)
(480) 244-6035
Entity
Organization
Contact information
Practice address
3401 LOCKWOOD DR, LAKESIDE, AZ 85929-5613
(928) 368-2060
(928) 368-2061
Mailing address
781 E MILLS PL, SHOW LOW, AZ 85901-6026
(480) 244-6035
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
12/27/2018
Last updated
12/27/2018
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