Healthcare Provider Details

I. General information

NPI: 1326661976
Provider Name (Legal Business Name): ELIZABETH J KYZER D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ELIZABETH JILL CROW

II. Dates (important events)

Enumeration Date: 05/18/2020
Last Update Date: 08/06/2024
Certification Date: 08/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 GROVE RD
GREENVILLE SC
29605-4210
US

IV. Provider business mailing address

300 E MCBEE AVE FL 4
GREENVILLE SC
29601-2842
US

V. Phone/Fax

Practice location:
  • Phone: 864-455-3287
  • Fax: 864-455-5723
Mailing address:
  • Phone: 864-695-6697
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number83220
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: