Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 075791 | GA |
N | 208600000X | Surgeon | 075791 | GA |
N | 208200000X | Surgeon | LP01703 | RI |
N | 208600000X | Surgeon | LP01703 | RI |
Y | 2086S0102X | Surgical Critical Care | 075791 | GA |
N | 2086S0127X | Trauma Surgeon | 075791 | GA |
NPI | 1033347232 |
---|---|
Provider Name | Dr. Elizabeth D Fox |
First Address | Augusta, GA 30912-0004 |
Second Address | Augusta, GA 30912-3033 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2009 |
Last Update Date | 09/08/2021 |