Goedde, Timothy A

Goedde, Timothy A is an sole proprietor health care provider with primary practice located at 7430 N Shadeland Ave Suite 230, Indianapolis IN 46250-2036. 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) 288-2456.

Contact Information

Primary practice address
7430 N Shadeland Ave Suite 230 Indianapolis IN 46250-2036
Phone: (317) 288-2456
Fax: (317) 288-2461
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 Yes
Enumeration date Jun 21st, 2005
Last updated Nov 27th, 2023 - about 2 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 1306841820 NPPES
Indiana MEDICAID 100441710
Indiana Other P01347706
Indiana Other 000000775120
Indiana Other 4258887

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