Organization
TIMOTHY A GOEDDE MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY A GOEDDE MD (OWNER)
(317) 288-2456
Entity
Organization
Contact information
Practice address
7430 N SHADELAND AVE, SUITE 230, INDIANAPOLIS, IN 46250-2036
(317) 288-2456
(317) 288-2461
Mailing address
7430 N SHADELAND AVE, SUITE 230, INDIANAPOLIS, IN 46250-2036
(317) 288-2456
(317) 288-2461
Taxonomy
Speciality
Code
Description
License number
State
2086X0206X
Surgical Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200870480A
—
IN
Enumeration date
07/25/2007
Last updated
03/19/2013
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