Provider Demographics
NPI:1477940609
Name:GOEL, HERSH VIVEK (MD)
Entity Type:Individual
Prefix:DR
First Name:HERSH
Middle Name:VIVEK
Last Name:GOEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3662 W INA RD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85741-2269
Mailing Address - Country:US
Mailing Address - Phone:520-302-5096
Mailing Address - Fax:
Practice Address - Street 1:90 W RIVER RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-5130
Practice Address - Country:US
Practice Address - Phone:520-302-5096
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-26
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ53576208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice