Provider Demographics
NPI:1871941054
Name:GOLDTHORPE, CLIFFORD SCOTT (DO)
Entity type:Individual
Prefix:
First Name:CLIFFORD
Middle Name:SCOTT
Last Name:GOLDTHORPE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:DR
Other - First Name:CLIFFORD
Other - Middle Name:SCOTT
Other - Last Name:GOLDTHORPE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:56 MEDICAL GROUP
Mailing Address - Street 2:7219 N LITCHFIELD RD
Mailing Address - City:LUKE AFB
Mailing Address - State:AZ
Mailing Address - Zip Code:85309
Mailing Address - Country:US
Mailing Address - Phone:801-664-5956
Mailing Address - Fax:
Practice Address - Street 1:56 MEDICAL GROUP
Practice Address - Street 2:7219 N LITCHFIELD RD
Practice Address - City:LUKE AFB
Practice Address - State:AZ
Practice Address - Zip Code:85309
Practice Address - Country:US
Practice Address - Phone:623-856-9753
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-30
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR7742207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery