Provider Demographics
NPI:1437372422
Name:GOOCH, DEBORAH K (DC)
Entity type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:K
Last Name:GOOCH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:MRS
Other - First Name:DEBORAH
Other - Middle Name:KATHERINE
Other - Last Name:HALL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 7556
Mailing Address - Street 2:
Mailing Address - City:CAVE CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85327
Mailing Address - Country:US
Mailing Address - Phone:480-575-8301
Mailing Address - Fax:480-575-8302
Practice Address - Street 1:25 EASY STREET
Practice Address - Street 2:ST B
Practice Address - City:CAREFREE
Practice Address - State:AZ
Practice Address - Zip Code:85377
Practice Address - Country:US
Practice Address - Phone:480-575-8301
Practice Address - Fax:480-575-8302
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7136111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0935700OtherBCBS
TX609208OtherMEDICARE
AZAZ0935700OtherBCBS