Provider Demographics
NPI:1841281136
Name:GOOSBY, DORSEY LAMAR (MD)
Entity type:Individual
Prefix:DR
First Name:DORSEY
Middle Name:LAMAR
Last Name:GOOSBY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:151 NW 11TH ST
Mailing Address - Street 2:SUITE E202
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33030-4360
Mailing Address - Country:US
Mailing Address - Phone:305-245-3220
Mailing Address - Fax:305-247-5849
Practice Address - Street 1:151 NW 11TH ST
Practice Address - Street 2:SUITE E202
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33030-4360
Practice Address - Country:US
Practice Address - Phone:305-245-3220
Practice Address - Fax:305-247-5849
Is Sole Proprietor?:No
Enumeration Date:2005-11-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME38862208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics