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General NPI Number Information
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NPI Number | 1831146901
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Entity Type | Individual
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Provider Name | ELIZABETH R WEATHERFORD M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/27/2006
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Last Update Date | 01/05/2011
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Provider Practice Location Address
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Address Line | 1404 E AVALON AVE
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City | TUSCUMBIA
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State | AL
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Zip | 35674-1773
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Country | US
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Telephone | 256-381-4400
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Fax | 256-381-4783
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Provider Business Mailing Address
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Address Line | PO BOX 298
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City | FLORENCE
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State | AL
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Zip | 35631-0298
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Country | US
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Telephone | 256-767-7494
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Fax | 256-760-8432
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 00015778
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License Number State | AL
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