Individual provider · Type 1 NPI

Kelly Goldsmith, DO

Student in an Organized Health Care Education/Training Program · Peoria, IL

NPI number 1306468822 Active

Practice location

1 Illini Dr
Peoria, IL 61605-2576

Call (858) 444-7309 Map

Mailing address

9505 E 203rd St
Peculiar, MO 64078-8792

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000X125.076125 (IL)

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1306468822

Kelly Goldsmith, DO's National Provider Identifier is 1306468822, issued on May 7, 2020. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Peoria, IL. The record was last updated on May 7, 2020.