GOLDEN TRIANGLE GERIATRIC COLLABORATIVE LLC NPI 1639442726

NPI Information

  • NPI: 1639442726
  • Provider Name: GOLDEN TRIANGLE GERIATRIC COLLABORATIVE, LLC
  • Classification: Clinical Nurse Specialist - 364SG0600X
  • Specialization: Gerontology
  • Entity Type: Organization
  • Address: 100 WILBURN WAY
    STARKVILLE, MS
    ZIP 39759
  • Phone: (662) 320-4008

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NPI Details

GOLDEN TRIANGLE GERIATRIC COLLABORATIVE, LLC is a gerontology clinical nurse specialist in Starkville, MS. GOLDEN TRIANGLE GERIATRIC COLLABORATIVE, LLC NPI is 1639442726. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

100 WILBURN WAY
STARKVILLE, MS
ZIP 39759-692
Phone: (662) 320-4008
Fax: (662) 323-6007

The provider's authorized official is Mary Atkinson Smith .
The authorized official title is Managing Partner and has the following contact phone number (662) 320-4008.

The enumeration date for this NPI number is 2/20/2012 and was last updated on 2/20/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1364SG0600XClinical Nurse SpecialistGerontologyR850904MISSISSIPPIYes

What is NPI?

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This page was last updated on: 11/21/2025

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