Provider Demographics
NPI:1033110762
Name:GOODE, JOEL R (MD)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:R
Last Name:GOODE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 31630
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85751-1630
Mailing Address - Country:US
Mailing Address - Phone:520-784-6200
Mailing Address - Fax:520-784-6109
Practice Address - Street 1:5301 E GRANT RD
Practice Address - Street 2:ORTHOPAEDIC BLDG, 1ST FLOOR
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-2805
Practice Address - Country:US
Practice Address - Phone:520-784-6200
Practice Address - Fax:520-784-6109
Is Sole Proprietor?:No
Enumeration Date:2005-08-03
Last Update Date:2015-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ28515207XS0106X, 207X00000X, 2086S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the Hand
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ519712Medicaid
AZ519712Medicaid
AZZ62872Medicare PIN