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General NPI Number Information
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NPI Number | 1336361732
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Entity Type | Organization
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Legal Business Name | TUSCALOOSA NEWBORN MEDICINE PC
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1820 RICE MINE RD NORTH SUITE 200
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City | TUSCALOOSA
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State | AL
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Zip | 35406-3282
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Country | US
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Telephone | 205-333-4661
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Fax | 205-333-4660
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Provider Business Mailing Address
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Address Line | 1820 RICE MINE RD NORTH SUITE 200
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City | TUSCALOOSA
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State | AL
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Zip | 35406-3282
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Country | US
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Telephone | 205-333-4661
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Fax | 205-333-4660
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Authorized Official
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Title or Position | PHYSICIAN OWNER
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Name | GUILLERMO GODOY
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Credential | M.D.
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Telephone | 205-333-4661
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | 11231
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License Number State | AL
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