MEDICARE: NATHAN W GOODYEAR 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	207VG0400X	Gynecology Physician	MD0000044259	TN
2	207V00000X	Obstetrics & Gynecology Physician	56029	AZ

General Provider Information

NPI Number	:	1538166970
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATHAN W GOODYEAR MD

Provider Business Mailing Address
First Line	:	11000 N SCOTTSDALE RD STE 115
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85254-6168
Country	:	US
Telephone Number	:	865-368-4557
Fax Number	:	888-673-1621

Provider Business Practice Location Address
First Line	:	11000 N SCOTTSDALE RD STE 115
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85254-6168
Country	:	US
Telephone Number	:	865-368-4557
Fax Number	:	888-673-1621

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

Provider Enumeration Date	:	06/30/2005
Last Update Date	:	03/05/2024

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