Goldsmith, Shannon L

Goldsmith, Shannon L is an individual health care provider with primary practice located at 822 Main St , Ellisville MS 39437-2425. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Goldsmith, Shannon L can be contacted via phone (601) 477-2014.

Contact Information

Primary practice address
822 Main St Ellisville MS 39437-2425
Phone: (601) 477-2014
Fax: (601) 477-9942
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 34009767 Ohio
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 24285 Mississippi

Profile Details

NPI number 1477748648
LBN Legal business name Goldsmith, Shannon L
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 11th, 2007
Last updated Jul 9th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1477748648 NPPES
Mississippi MEDICAID 07854358
Mississippi Other 12114080
Mississippi MEDICAID 3056277
Mississippi MEDICAID 0236248

Popular Providers