MEDICARE: DR. ELIZABETH ANN SPRINGER 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
1	207NS0135X	Procedural Dermatology Physician	01040859A	IN

General Provider Information

NPI Number	:	1841273513
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELIZABETH ANN SPRINGER MD

Provider Business Mailing Address
First Line	:	1516 119TH ST
Second Line	:
City	:	WHITING
State	:	IN
Zip	:	46394-1733
Country	:	US
Telephone Number	:	219-921-6688
Fax Number	:

Provider Business Practice Location Address
First Line	:	1516 119TH ST
Second Line	:
City	:	WHITING
State	:	IN
Zip	:	46394-1733
Country	:	US
Telephone Number	:	219-921-6688
Fax Number	:

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

Provider Enumeration Date	:	11/27/2005
Last Update Date	:	05/02/2020

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