Healthcare Provider Details

I. General information

NPI: 1306155262
Provider Name (Legal Business Name): ELIZABETH CROW MD, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2010
Last Update Date: 03/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

129 E 7TH AVE
ANCHORAGE AK
99501-3607
US

IV. Provider business mailing address

129 E 7TH AVE
ANCHORAGE AK
99501-3607
US

V. Phone/Fax

Practice location:
  • Phone: 907-562-2965
  • Fax: 907-561-1257
Mailing address:
  • Phone: 907-562-2965
  • Fax: 907-561-1257

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number4533
License Number StateAK

VIII. Authorized Official

Name: DR. ELIZABETH A. CROW
Title or Position: OWNER
Credential: MD
Phone: 907-562-2965