Provider Demographics
NPI:1750398434
Name:MATHISON, ELIZABETH G (MD)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:G
Last Name:MATHISON
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:2270 HILLCREST RD
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36695-3808
Mailing Address - Country:US
Mailing Address - Phone:251-666-2213
Mailing Address - Fax:251-660-8037
Practice Address - Street 1:1924K DAUPHIN ISLAND PKWY
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36605-3004
Practice Address - Country:US
Practice Address - Phone:251-476-6330
Practice Address - Fax:251-450-1352
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2010-07-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AL00018550207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALF91471Medicare UPIN
31275Medicare ID - Type Unspecified