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General NPI Number Information
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NPI Number | 1558463125
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Entity Type | Individual
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Provider Name | ELIZABETH ANN ERICKSON M.D.
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Gender | Female
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Dates
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Enumeration Date | 09/02/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | UNIT 7095 BOX 185
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City | APO
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State | NY
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Zip | 09824
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Country | TR
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Telephone | 903223163141
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Fax |
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Provider Business Mailing Address
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Address Line | PSC 94 BOX 2461
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City | APO
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State | AE
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Zip | 09824
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Country | TR
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 01059762A
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License Number State | IN
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