Golisch, Tara

Golisch, Tara is an individual health care provider with primary practice located at 4800 N 22Nd St , Phoenix AZ 85016-4701. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Ophthalmology, Allopathic & Osteopathic Physicians / Glaucoma Specialist. Allopathic & Osteopathic Physicians / Glaucoma Specialist is her primary health care specialty. Golisch, Tara can be contacted via phone (602) 955-1000.

Contact Information

Primary practice address
4800 N 22Nd St Phoenix AZ 85016-4701
Phone: (602) 955-1000
Fax: (602) 508-4830
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X TP099 Kentucky
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 55265 Arizona
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 35121199 Ohio
Allopathic & Osteopathic Physicians / Glaucoma Specialist 207WX0009X 55265 Arizona

Profile Details

NPI number 1083841704
LBN Legal business name Golisch, Tara
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 20th, 2009
Last updated Apr 30th, 2019 - about 7 years ago

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1083841704 NPPES
Arizona MEDICAID 332409

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