Provider Demographics
NPI:1013261684
Name:GOODEILL, ANDREW (DPM)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:
Last Name:GOODEILL
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
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Mailing Address - Street 1:4915 E BASELINE RD
Mailing Address - Street 2:STE 121
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85234-2969
Mailing Address - Country:US
Mailing Address - Phone:480-812-3668
Mailing Address - Fax:480-782-1290
Practice Address - Street 1:4915 E BASELINE RD
Practice Address - Street 2:STE 121
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234-2969
Practice Address - Country:US
Practice Address - Phone:480-812-3668
Practice Address - Fax:480-782-1290
Is Sole Proprietor?:No
Enumeration Date:2012-11-05
Last Update Date:2020-08-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZPD-000950213E00000X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist