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General NPI Number Information
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NPI Number | 1568452977
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Entity Type | Individual
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Provider Name | ELIZABETH ANN CARR D.O.
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Gender | Female
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Dates
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Enumeration Date | 10/26/2005
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Last Update Date | 11/12/2018
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Provider Practice Location Address
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Address Line | 3636 HIGH ST
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City | PORTSMOUTH
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State | VA
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Zip | 23707-3236
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Country | US
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Telephone | 757-398-4280
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Fax | 757-397-5368
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Provider Business Mailing Address
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Address Line | 2 TIDES CT
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City | PORTSMOUTH
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State | VA
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Zip | 23703-5410
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Country | US
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Telephone | 267-290-9913
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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 | OS00853L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | H0076223
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 0102204081
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License Number State | VA
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