Basic Information
| Provider Information | |||||||||
| NPI: | 1356727051 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GOLDEN | ||||||||
| FirstName: | FRANKLIN | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 247 | ||||||||
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| City: | LAUREL | ||||||||
| State: | MS | ||||||||
| PostalCode: | 394410247 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6014257550 | ||||||||
| FaxNumber: | 6013996281 | ||||||||
| Practice Location | |||||||||
| Address1: | 5 DUNNBARR | ||||||||
| Address2: | SUITE 1 | ||||||||
| City: | LAUREL | ||||||||
| State: | MS | ||||||||
| PostalCode: | 394401041 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6014269614 | ||||||||
| FaxNumber: | 6013991592 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/04/2015 | ||||||||
| LastUpdateDate: | 10/05/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0808X | R877882 | MS | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.