Individual
DR. KENNETH E. GOOLSBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 S ENOTA DR NE, GAINESVILLE, GA 30501-3473
(770) 534-8832
(770) 531-7479
Mailing address
200 S ENOTA DR NE, SUITE 300, GAINESVILLE, GA 30501-3473
(770) 534-8832
(770) 531-7479
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
025162
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00358586C
—
GA
Enumeration date
07/30/2006
Last updated
07/08/2007
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