Healthcare Provider Details

I. General information

NPI: 1447224340
Provider Name (Legal Business Name): JEFFREY F GOLDSMITH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/15/2006
Last Update Date: 08/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1924 PIEDMONT RD NE
ATLANTA GA
30324-4117
US

IV. Provider business mailing address

1924 PIEDMONT RD NE
ATLANTA GA
30324-4117
US

V. Phone/Fax

Practice location:
  • Phone: 404-881-0966
  • Fax:
Mailing address:
  • Phone: 404-881-0966
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License Number67127
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number67127
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: