Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | 14642 | SC |
NPI | 1033218656 |
---|---|
Provider Name | Elizabeth Louise Foxworth |
First Address | Greenville, SC 29615-6300 |
Second Address | Greenville, SC 29605-5611 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
146425 | (05) | SC |
20009598 | SELECT HEALTH (01) | SC |
F44573 | (02) | SC |