# WHITE MOUNTAIN MEDICAL CONSULTANTS LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508338831
- **Authorized official:** DR. BRIAN WILLIAM GOODMAN DO (TAX ID, PRACTICE OWNER)
- **Authorized official phone:** (480) 244-6035

## Contact information

- **Practice address:** 3401 LOCKWOOD DR, LAKESIDE, AZ 85929-5613
- **Practice address phone:** (928) 368-2060
- **Practice address fax:** (928) 368-2061
- **Mailing address:** 781 E MILLS PL, SHOW LOW, AZ 85901-6026
- **Mailing address phone:** (480) 244-6035

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/27/2018
- **Last updated:** 12/27/2018