Provider Demographics
NPI:1316359011
Name:GOLDEN, MOLLIE JO (OD)
Entity Type:Individual
Prefix:DR
First Name:MOLLIE
Middle Name:JO
Last Name:GOLDEN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:810 W REID AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:NORTH PLATTE
Mailing Address - State:NE
Mailing Address - Zip Code:69101-6582
Mailing Address - Country:US
Mailing Address - Phone:308-221-2020
Mailing Address - Fax:308-221-6017
Practice Address - Street 1:810 W REID AVE STE 1
Practice Address - Street 2:
Practice Address - City:NORTH PLATTE
Practice Address - State:NE
Practice Address - Zip Code:69101-6582
Practice Address - Country:US
Practice Address - Phone:308-221-2020
Practice Address - Fax:308-221-6017
Is Sole Proprietor?:No
Enumeration Date:2014-05-29
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1416152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist