Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | E 5711 | AR |
NPI | 1003038167 |
---|---|
Provider Name | Dr. Kimberly Kay Golden |
First Address | Jackson, MS 39204-5228 |
Second Address | Rison, AR 71665 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2007 |
Last Update Date | 28/10/2008 |