Individual
TARA GOLISCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4800 N 22ND ST, PHOENIX, AZ 85016-4701
(602) 955-1000
(602) 508-4830
Mailing address
4800 N 22ND ST, PHOENIX, AZ 85016-4701
(602) 955-1000
(602) 508-4830
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
35121199
OH
207W00000X
Ophthalmology Physician
55265
AZ
207W00000X
Ophthalmology Physician
TP099
KY
207WX0009X
Glaucoma Specialist (Ophthalmology) Physician
Primary
55265
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
332409
—
AZ
Enumeration date
06/20/2009
Last updated
04/30/2019
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