Provider Demographics
NPI:1124070941
Name:GOLDSMITHFLETCHER, CYNTHIA M (MD)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:M
Last Name:GOLDSMITHFLETCHER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 LEIGHTON AVE
Mailing Address - Street 2:SUITE 501
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36207-5700
Mailing Address - Country:US
Mailing Address - Phone:256-237-6755
Mailing Address - Fax:256-236-1823
Practice Address - Street 1:901 LEIGHTON AVE
Practice Address - Street 2:SUITE 501
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36207-5765
Practice Address - Country:US
Practice Address - Phone:256-237-6755
Practice Address - Fax:256-236-1823
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2014-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL26231174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL630408152Medicaid
I22093Medicare UPIN