Individual
DR. BRADLEY PORTER GOODSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1850 N CENTRAL AVE, STE 1600, PHOENIX, AZ 85004-4633
(602) 262-8900
Mailing address
1850 N CENTRAL AVE, STE 1600, PHOENIX, AZ 85004-4633
(602) 262-8900
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
007678
AZ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/23/2014
Last updated
10/09/2018
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