Individual
DR. CLIVE ANTHONY GOULBOURNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1235 E CHEROKEE ST, SPRINGFIELD, MO 65804-2203
(417) 820-3911
Mailing address
1235 E CHEROKEE ST, SPRINGFIELD, MO 65804-2203
(417) 820-3911
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
2022040707
MO
207RC0000X
Cardiovascular Disease Physician
87980
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/01/2014
Last updated
12/01/2022
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