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Individual

JOHN E GOODPASTURE JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1955 W FRYE RD, CHANDLER, AZ 85224-6282
(480) 728-3000
(480) 507-2971
Mailing address
PO BOX 1847, GILBERT, AZ 85299-1847
(480) 507-2961
(480) 507-2971

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
47111
AZ
207L00000X
Anesthesiology Physician
E2578
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
157212501
TX
05
829085
AZ
Enumeration date
10/31/2005
Last updated
10/28/2013
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