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General NPI Number Information
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NPI Number | 1104843192
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Entity Type | Individual
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Provider Name | RUPA D GOOLSBY M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/16/2006
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Last Update Date | 09/01/2015
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Provider Practice Location Address
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Address Line | 800 SAINT VINCENTS DR NORTH TOWER SUITE 600
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City | BIRMINGHAM
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State | AL
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Zip | 35205-1620
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Country | US
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Telephone | 205-271-1600
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Fax | 205-271-3167
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Provider Business Mailing Address
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Address Line | 800 SAINT VINCENTS DR SUITE 600
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City | BIRMINGHAM
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State | AL
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Zip | 35205-1620
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Country | US
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Telephone | 205-271-1600
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 16758
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License Number State | AL
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