Goodman, Warren G

Goodman, Warren G is an individual health care provider with primary practice located at 1000 Ainsworth Dr Suite 115, Prescott AZ 86305-1667. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Goodman, Warren G can be contacted via phone (928) 778-1971.

Contact Information

Primary practice address
1000 Ainsworth Dr Suite 115 Prescott AZ 86305-1667
Fax: (928) 771-0638
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 15335 Arizona

Profile Details

NPI number 1396731352
LBN Legal business name Goodman, Warren G
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 26th, 2005
Last updated Jul 8th, 2007 - about 15 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 1396731352 NPPES
Arizona MEDICAID 272443

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