Provider Demographics
NPI:1861563256
Name:GOLDSMITH, KAREN A (DC)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:A
Last Name:GOLDSMITH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4542 RAEFORD RD STE B1
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-3203
Mailing Address - Country:US
Mailing Address - Phone:910-426-2272
Mailing Address - Fax:910-426-0121
Practice Address - Street 1:4542 RAEFORD RD STE B1
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-3203
Practice Address - Country:US
Practice Address - Phone:910-426-2272
Practice Address - Fax:910-426-0121
Is Sole Proprietor?:No
Enumeration Date:2006-11-10
Last Update Date:2008-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2817111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCU83912Medicare UPIN
NC2454113Medicare ID - Type Unspecified