MEDICARE: HGL CORPORATION

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	207Q00000X	Family Medicine Physician	2014	AZ
2	207RC0000X	Cardiovascular Disease Physician	2800	AZ
3	207Q00000X	Family Medicine Physician	7607	AZ

General Provider Information

NPI Number	:	1134289978
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HGL CORPORATION

Provider Business Mailing Address
First Line	:	11045 N 19TH AVE
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85029-4816
Country	:	US
Telephone Number	:	602-944-4474
Fax Number	:	602-944-0194

Provider Business Practice Location Address
First Line	:	11045 N 19TH AVE
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85029-4816
Country	:	US
Telephone Number	:	602-944-4474
Fax Number	:	602-944-0194

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DR. HERBERT D GOODMAN
Credential	:	M.D.
Telephone Number	:	602-944-4474

Provider Enumeration Date	:	12/11/2006
Last Update Date	:	09/11/2025

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1730496282 — MS. JULIE ANN OVERBEY MS-FNP
Practice Location Address:

11047 N 19TH AVE
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85029-4816

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1558318295 — ALFONSO E ROGGIERO P.A.-C.
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85029-4816

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1326055179 — MR. MOHAMMAD ALI HABIB M.D.
Practice Location Address:

11045 N 19TH AVE
PHOENIX, AZ
85029-4816

Practice Phone: 602-944-4474
Practice Fax: 602-331-5076

1346258472 — HERBERT D GOODMAN M.D.
Practice Location Address:

11045 N 19TH AVE
PHOENIX, AZ
85029-4816

Practice Phone: 602-944-4474
Practice Fax: 602-943-7829

1215047766 — MR. JOHN ROBERT KECK N.P.
Practice Location Address:

11047 N 19TH AVE
PHOENIX, AZ
85029-4816

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1255469599 — DR. JASON E GITTMAN M.D.
Practice Location Address:

11045 N 19TH AVE
PHOENIX, AZ
85029-4816

Practice Phone: 623-849-1869
Practice Fax: 623-849-5880

Directions to “HGL CORPORATION ” Practice Location

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