Provider Demographics
NPI:1487696605
Name:RACKOFF, ELISE MARIE JACKSON (MD)
Entity type:Individual
Prefix:DR
First Name:ELISE MARIE
Middle Name:JACKSON
Last Name:RACKOFF
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Gender:F
Credentials:MD
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Mailing Address - Street 1:16 MEDICAL PARK DR
Mailing Address - Street 2:ADVANCED DERMATOLOGY & SKIN SURGERY, PA
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-2493
Mailing Address - Country:US
Mailing Address - Phone:828-274-4880
Mailing Address - Fax:828-274-6868
Practice Address - Street 1:16 MEDICAL PARK DR
Practice Address - Street 2:ADVANCED DERMATOLOGY & SKIN SURGERY, PA
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-2493
Practice Address - Country:US
Practice Address - Phone:828-274-4880
Practice Address - Fax:828-274-6868
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2014-02-24
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Provider Licenses
StateLicense IDTaxonomies
NC200900259207N00000X
FLME95232207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology