Individual
JAMES P GOOLSBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
407 S SCHWARTZ AVE, SUITE 101, FARMINGTON, NM 87401-5925
(505) 609-6770
(505) 609-6775
Mailing address
407 S SCHWARTZ AVE, SUITE 101, FARMINGTON, NM 87401-5925
(505) 609-6770
(505) 609-6775
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
F2691
TX
207RC0000X
Cardiovascular Disease Physician
Primary
MD2004-0655
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
048690
GREAT WEST
—
01
—
110043155
RAILROAD MEDICARE
—
05
—
1238776-03
—
TX
05
—
47989351
—
NM
01
—
722439
FIRST HEALTH
TX
01
—
78756-A014
CHAMPUS/TRICARE
—
01
—
881627
BC/BS
TX
Enumeration date
08/03/2005
Last updated
05/07/2013
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