MEDICARE: DR. CHAD GOETZ N.M.D.

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	175F00000X	Naturopath	04-838	AZ

General Provider Information

NPI Number	:	1780679571
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHAD GOETZ N.M.D.

Provider Business Mailing Address
First Line	:	16286 SOUTH SUNLAND GIN ROAD
Second Line	:
City	:	ARIZONA CITY
State	:	AZ
Zip	:	85123
Country	:	US
Telephone Number	:	520-494-8077
Fax Number	:	502-494-8081

Provider Business Practice Location Address
First Line	:	16286 SOUTH SUNLAND GIN ROAD
Second Line	:
City	:	ARIZONA CITY
State	:	AZ
Zip	:	85123
Country	:	US
Telephone Number	:	520-494-8077
Fax Number	:	520-494-8081

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

Provider Enumeration Date	:	09/16/2005
Last Update Date	:	01/31/2019

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