Healthcare Provider Details

I. General information

NPI: 1831779537
Provider Name (Legal Business Name): ELIZABETH LYNNE TUPPER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2021
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 PERRI AVE
MYERSTOWN PA
17067-3200
US

IV. Provider business mailing address

116 S GEORGE ST
YORK PA
17401-1474
US

V. Phone/Fax

Practice location:
  • Phone: 717-949-6581
  • Fax: 717-949-2816
Mailing address:
  • Phone: 717-845-8617
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD486446
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: