Provider Demographics
NPI:1154483345
Name:PONTZER, LIZABETH JANE (MD)
Entity Type:Individual
Prefix:DR
First Name:LIZABETH
Middle Name:JANE
Last Name:PONTZER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:324 NORTHVIEW CT
Mailing Address - Street 2:
Mailing Address - City:WILLISTON
Mailing Address - State:VT
Mailing Address - Zip Code:05495-7353
Mailing Address - Country:US
Mailing Address - Phone:802-578-2756
Mailing Address - Fax:
Practice Address - Street 1:366 DORSET ST
Practice Address - Street 2:SUITE 10, STONE HOUSE ASSOCIATES
Practice Address - City:SOUTH BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05403-6209
Practice Address - Country:US
Practice Address - Phone:802-654-7607
Practice Address - Fax:802-654-9155
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2009-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT042-00112612084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry