Individual
BRANDON GOLDSMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5452
(601) 815-3322
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5452
(601) 815-3322
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R882781
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04586367
—
MS
05
—
178296
—
AL
01
—
P01454795
RAILROAD MEDICARE PTAN
MS
Enumeration date
07/11/2014
Last updated
03/01/2016
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