Doctor Name: | PATRICK JAMES GOBLE |
NPI Number: | 1154759611 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PHYSICIAN ASSISTANT |
License Number: | |
Business Practice Address: | 1650 Cochrane Cir Fort Carson, CO - 809134613 |
Business Phone Number: | 7195267000 |
Business Fax Number: | |
Mailing Address: | 1650 Cochrane Cir, FORT CARSON |
State: | CO |
Postal Code: | 809134613 |
Phone Number: | 7195267000 |
Fax Number: | |
NPI Enumeration Date: | 10/21/2013 |
NPI Last Update Date: | 10/21/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |