White Mountain Medical Consultants LLC

NPI #1508338831 in Lakeside, Arizona

Provider Information

NPI Number: 1508338831
Entity Type: Organization
Organization Name: White Mountain Medical Consultants LLC
Primary Specialty: Family Medicine
Enumeration Date: Dec 27, 2018
Last Updated: Dec 27, 2018

Practice Location

Address: 3401 LOCKWOOD DR
City: Lakeside
State: Arizona
ZIP Code: 85929-5613
Phone: (928) 368-2060

Authorized Official

Name: DR. BRIAN WILLIAM GOODMAN, DO
Title: TAX ID, PRACTICE OWNER
Phone: (480) 244-6035

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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