Wiseman, Richard Goodman

Wiseman, Richard Goodman is an individual health care provider with primary practice located at 538 J M Ash Dr , Holly Springs MS 38635-3238. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Wiseman, Richard Goodman can be contacted via phone (662) 252-1599.

Contact Information

Primary practice address
538 J M Ash Dr Holly Springs MS 38635-3238
Phone: (662) 252-1599
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X R549096 Mississippi

Profile Details

NPI number 1871690263
LBN Legal business name Wiseman, Richard Goodman
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 20th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1871690263 NPPES
Mississippi MEDICAID 00114188

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