MEDICARE: JOHN T GOODSELL DO PC GREGORY LINDERER MD LTD

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	207L00000X	Anesthesiology Physician

General Provider Information

NPI Number	:	1427000413
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOHN T GOODSELL DO PC GREGORY LINDERER MD LTD

Provider Business Mailing Address
First Line	:	129 W LAKE MEAD PKWY
Second Line	:	#B-18
City	:	HENDERSON
State	:	NV
Zip	:	89015-7055
Country	:	US
Telephone Number	:	702-564-4440
Fax Number	:	702-558-1522

Provider Business Practice Location Address
First Line	:	129 W LAKE MEAD PKWY
Second Line	:	#B-18
City	:	HENDERSON
State	:	NV
Zip	:	89015-7055
Country	:	US
Telephone Number	:	702-564-4440
Fax Number	:	702-558-1522

Authorized Official
Title or Position	:	CORPORATE PARTNER
Name	:	DR. JOHN T GOODSELL
Credential	:	DO
Telephone Number	:	702-564-4440

Provider Enumeration Date	:	05/17/2006
Last Update Date	:	01/28/2011

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