MEDICARE: BRAD GOLNER 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	208000000X	Pediatrics Physician	24993	AZ

General Provider Information

NPI Number	:	1194816702
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRAD GOLNER MD

Provider Business Mailing Address
First Line	:	4735 E UNION HILLS DR
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85050-3362
Country	:	US
Telephone Number	:	602-971-5121
Fax Number	:	602-971-3122

Provider Business Practice Location Address
First Line	:	4735 E UNION HILLS DR
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85050-3362
Country	:	US
Telephone Number	:	602-971-5121
Fax Number	:	602-971-3122

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

Provider Enumeration Date	:	09/27/2006
Last Update Date	:	08/29/2023

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