Goforth, Mark A
Goforth, Mark A is an individual health care provider with primary practice located at 14029 E Camino Galante , Vail AZ 85641-2067. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Goforth, Mark A can be contacted via phone (520) 904-7987.Contact Information
Primary practice address
14029 E Camino Galante
Vail AZ 85641-2067
Phone: (520) 904-7987
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | AP4993 | Arizona |
Profile Details
| NPI number | 1699198747 |
|---|---|
| LBN Legal business name | Goforth, Mark A |
| Credentials | NURSE PRACTITIONER |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 27th, 2014 |
| Last updated | Jan 27th, 2014 - about 10 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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