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NPI Code Detail

MEDICARE: DR. ELIZABETH S FARNSWORTH MD, PHD

MEDICARE: DR. ELIZABETH S FARNSWORTH MD, PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program
2208000000XPediatrics Physician76112MT
3208000000XPediatrics Physician13538SD

General Provider Information

NPI Number : 1174973853
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ELIZABETH S FARNSWORTH MD, PHD
Provider Business Mailing Address
First Line : 2820 MOUNT RUSHMORE RD
Second Line :
City : RAPID CITY
State : SD
Zip : 57701-5474
Country : US
Telephone Number : 605-342-3280
Fax Number :
Provider Business Practice Location Address
First Line : 2820 MOUNT RUSHMORE RD
Second Line :
City : RAPID CITY
State : SD
Zip : 57701-5474
Country : US
Telephone Number : 605-342-3280
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2016
Last Update Date : 12/17/2024

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