Goedde, Timothy A
Goedde, Timothy A is an individual health care provider with primary practice located at 7501 Pine Royal Dr , Indianapolis IN 46256-3264. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Surgical Oncology. Allopathic & Osteopathic Physicians / Surgical Oncology is his primary health care specialty. Goedde, Timothy A can be contacted via phone (317) 201-1190.Contact Information
Primary practice address
7501 Pine Royal Dr
Indianapolis IN 46256-3264
Phone: (317) 201-1190
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 01039996A | Indiana |
| Allopathic & Osteopathic Physicians / Surgical Oncology | 2086X0206X | 01039996A | Indiana |
Profile Details
| NPI number | 1306841820 |
|---|---|
| LBN Legal business name | Goedde, Timothy A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 21st, 2005 |
| Last updated | Jan 2nd, 2025 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1306841820 | NPPES |
| Indiana | Other | P01347706 | MEDICARE RR PTAN |
| Indiana | MEDICAID | 100441710 | MEDICARE RR PTAN |
| Indiana | Other | 000000775120 | MEDICARE RR PTAN |
| Indiana | Other | 4258887 | MEDICARE RR PTAN |
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