Provider Demographics
NPI:1225097686
Name:HUBBARD, ELIZABETH W (MD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:W
Last Name:HUBBARD
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1924 ALCOA HIGHWAY
Mailing Address - Street 2:THE UNIVERSITY OF TENNESSEE MEDICAL CENTER PATH DEPT
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920-6999
Mailing Address - Country:US
Mailing Address - Phone:865-305-9080
Mailing Address - Fax:865-305-6866
Practice Address - Street 1:1924 ALCOA HIGHWAY
Practice Address - Street 2:THE UNIVERSITY OF TENNESSEE MEDICAL CENTER PATH DEPT
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-6999
Practice Address - Country:US
Practice Address - Phone:865-305-9080
Practice Address - Fax:865-305-6866
Is Sole Proprietor?:No
Enumeration Date:2006-03-22
Last Update Date:2010-08-24
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Provider Licenses
StateLicense IDTaxonomies
TN20519207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3061339Medicaid
TN3061339Medicaid
3061339Medicare ID - Type Unspecified