Provider Demographics
NPI:1336708601
Name:GOETZ, JOSHUA JAMES (OD)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:JAMES
Last Name:GOETZ
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20737 E CALEY PL
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80016-1130
Mailing Address - Country:US
Mailing Address - Phone:303-476-0356
Mailing Address - Fax:
Practice Address - Street 1:6380 PROMENADE PKWY STE A-100
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80108-1909
Practice Address - Country:US
Practice Address - Phone:720-475-9991
Practice Address - Fax:720-480-9991
Is Sole Proprietor?:No
Enumeration Date:2019-06-11
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCO3483152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist