MEDICARE: MR. THOMAS R GOODINE 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
1	207X00000X	Orthopaedic Surgery Physician	60108	AZ
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1366931354
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. THOMAS R GOODINE MD

Provider Business Mailing Address
First Line	:	2500 W UTOPIA RD STE 100
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85027-4172
Country	:	US
Telephone Number	:	623-683-4462
Fax Number	:	623-683-4963

Provider Business Practice Location Address
First Line	:	9250 N 3RD ST STE 2035
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85020-2407
Country	:	US
Telephone Number	:	623-683-8000
Fax Number	:	623-259-1711

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/04/2018
Last Update Date	:	11/25/2025

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Directions to “ MR. THOMAS R GOODINE MD” Practice Location

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