Provider Demographics
NPI:1083134597
Name:DANIEL PAUL GOLIGHTLY MD LLC
Entity Type:Organization
Organization Name:DANIEL PAUL GOLIGHTLY MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:M
Authorized Official - Last Name:HOSTEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-921-2469
Mailing Address - Street 1:3188 ATLANTA RD SE
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-8256
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:770-319-6330
Practice Address - Street 1:3188 ATLANTA RD SE
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080
Practice Address - Country:US
Practice Address - Phone:770-319-6000
Practice Address - Fax:770-319-6330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-26
Last Update Date:2017-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health