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Individual

JONATHAN GOODMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
13188 N 103RD DR, STE 206, SUN CITY, AZ 85351-3064
(623) 972-3001
(623) 933-3045
Mailing address
13188 N 103RD DR, STE 206, SUN CITY, AZ 85351-3064
(623) 972-3001
(623) 933-3045

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
33921
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
957912
AZ
Enumeration date
06/05/2006
Last updated
03/03/2011
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