Healthcare Provider Details
I. General information
NPI: 1710941729
Provider Name (Legal Business Name): LAURA H. GOETZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/14/2006
Last Update Date: 07/13/2025
Certification Date: 07/13/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10510 N 92ND ST STE 200
SCOTTSDALE AZ
85258-4566
US
IV. Provider business mailing address
10510 N 92ND ST STE 200
SCOTTSDALE AZ
85258-4566
US
V. Phone/Fax
- Phone: 480-323-1350
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2083B0002X |
| Taxonomy | Obesity Medicine (Preventive Medicine) Physician |
| License Number | 57872 |
| License Number State | AZ |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | A86535 |
| License Number State | CA |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2083P0901X |
| Taxonomy | Public Health & General Preventive Medicine Physician |
| License Number | 57872 |
| License Number State | AZ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: