MEDICARE: ELIZABETH MACARTHUR BS PT , CIMI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT004730	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	121002	OTHER		BCBS PIN

General Provider Information

NPI Number	:	1053481325
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH MACARTHUR BS PT , CIMI

Provider Business Mailing Address
First Line	:	500 PINE FOREST RD NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30342-2764
Country	:	US
Telephone Number	:	404-784-7083
Fax Number	:	404-531-9290

Provider Business Practice Location Address
First Line	:	1000 HOLCOMB WOODS PKWY
Second Line	:	STE 426
City	:	ROSWELL
State	:	GA
Zip	:	30076-2575
Country	:	US
Telephone Number	:	770-851-9553
Fax Number	:	770-698-4178

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2006
Last Update Date	:	07/09/2007

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