# GOLDEN TRIANGLE GERIATRIC COLLABORATIVE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639442726
- **Authorized official:** DR. MARY ATKINSON SMITH FNP (MANAGING PARTNER)
- **Authorized official phone:** (662) 320-4008

## Contact information

- **Practice address:** 100 WILBURN WAY, STARKVILLE, MS 39759-3692
- **Practice address phone:** (662) 320-4008
- **Practice address fax:** (662) 323-6007
- **Mailing address:** 100 WILBURN WAY, STARKVILLE, MS 39759-3692
- **Mailing address phone:** (662) 320-4008
- **Mailing address fax:** (662) 323-6007

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 364SG0600X | Gerontology Clinical Nurse Specialist | R850904 | MS | Yes |

## Other

- **Enumeration date:** 02/20/2012
- **Last updated:** 02/20/2012