Organization
WHITE MOUNTAIN MEDICAL CONSULTANTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN WILLIAM GOODMAN DO (TAX ID, PRACTICE OWNER)
(480) 244-6035
Entity
Organization
Contact information
Practice address
3401 LOCKWOOD DR, LAKESIDE, AZ 85929-5613
(928) 368-2060
(928) 368-2061
Mailing address
781 E MILLS PL, SHOW LOW, AZ 85901-6026
(480) 244-6035
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
12/27/2018
Last updated
12/27/2018
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