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:
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 | Yes |
Enumeration date | Jun 21st, 2005 |
Last updated | Nov 27th, 2023 - 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 | MEDICAID | 100441710 | |
Indiana | Other | P01347706 | |
Indiana | Other | 000000775120 | |
Indiana | Other | 4258887 |
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