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NPI Code Detail

MEDICARE: WILLIAM LEE ELZI MD

MEDICARE: WILLIAM LEE ELZI MD
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
1207R00000XInternal Medicine Physician34053CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1164500245
Entity Type Code : Individual
Provider Name (Legal Business Name) : WILLIAM LEE ELZI MD
Provider Business Mailing Address
First Line : 405 COLLIER RANCH RD
Second Line :
City : STEPHENVILLE
State : TX
Zip : 76401-1988
Country : US
Telephone Number : 702-453-3799
Fax Number : 702-453-5741
Provider Business Practice Location Address
First Line : 1338 PHAY AVE
Second Line :
City : CANON CITY
State : CO
Zip : 81212-2302
Country : US
Telephone Number : 720-938-5022
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/02/2006
Last Update Date : 08/18/2021

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