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NPI Code Detail

MEDICARE: DR. DAVID R GOFF MD

MEDICARE: DR. DAVID R GOFF MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RC0000XCardiovascular Disease Physician2626761205UT
22086S0129XVascular Surgery Physician2626761205UT
3208G00000XThoracic Surgery (Cardiothoracic Vascular Surgery) Physician262676-1205UT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1255449351
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAVID R GOFF MD
Provider Business Mailing Address
First Line : PO BOX 27128
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84127-0128
Country : US
Telephone Number : 801-387-3475
Fax Number :
Provider Business Practice Location Address
First Line : 4403 HARRISON BLVD STE 3450
Second Line :
City : OGDEN
State : UT
Zip : 84403-3282
Country : US
Telephone Number : 801-387-3475
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/28/2006
Last Update Date : 05/03/2011

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