DR. CLIVE ANTHONY GOULBOURNE MD NPI 1083024970

NPI Information

NPI: 1083024970
Provider Name: DR. CLIVE ANTHONY GOULBOURNE, MD
Classification: Internal Medicine - 207RC0000X
Entity Type: Individual

Specialization: Cardiovascular Disease

PECOS Registration: Yes

Address:
1235 E CHEROKEE ST
SPRINGFIELD, MO
ZIP 65804
Phone: (417) 820-3911
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DR. Clive Anthony Goulbourne, MD is a cardiovascular disease internal medicine in Springfield, MO with 15 years of experience. The provider is an internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. DR. Clive Anthony Goulbourne, MD NPI is 1083024970. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1235 E CHEROKEE ST
SPRINGFIELD, MO
ZIP 65804-203
Phone: (417) 820-3911

The NPI 1083024970 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/1/2014 and was last updated on 12/1/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207RC0000X	Internal Medicine	Cardiovascular Disease	87980	GEORGIA	No
2	390200000X	Student in an Organized Health Care Education/Training Program				No
3	207RC0000X	Internal Medicine	Cardiovascular Disease	2022040707	MISSOURI	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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