Individual
DR. BLAIR T GOODSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
302 EL CAMINO REAL, SUITE 5, SIERRA VISTA, AZ 85635-2860
(520) 459-3920
(520) 452-2218
Mailing address
5750 E HIGHWAY 90, STE 200, SIERRA VISTA, AZ 85635-9113
(520) 458-4335
(520) 452-2232
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2298
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
280214
—
AZ
Enumeration date
07/20/2006
Last updated
06/09/2016
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