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Organization

ARIZONA EM-I MEDICAL SERVICES, P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DONALD T GODBOLD MD (PRESIDENT)
(805) 563-3011
Entity
Organization

Contact information

Practice address
101 CIVIC CENTER LN, LAKE HAVASU CITY, AZ 86403-5607
(928) 453-0150
Mailing address
3916 STATE ST, SUITE 300, SANTA BARBARA, CA 93105-5602
(805) 563-3011

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
363A00000X
Physician Assistant
363L00000X
Nurse Practitioner

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
DF3653
RAILROAD
AZ
Enumeration date
05/08/2006
Last updated
01/28/2010
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