Provider Demographics
NPI:1235426156
Name:OVEN, ELIZABETH (DO)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:
Last Name:OVEN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:TEVALD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:210 N MERCER ST
Mailing Address - Street 2:
Mailing Address - City:LINESVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16424-9232
Mailing Address - Country:US
Mailing Address - Phone:814-683-4636
Mailing Address - Fax:814-683-5869
Practice Address - Street 1:210 N MERCER ST
Practice Address - Street 2:
Practice Address - City:LINESVILLE
Practice Address - State:PA
Practice Address - Zip Code:16424-9232
Practice Address - Country:US
Practice Address - Phone:814-683-4636
Practice Address - Fax:814-683-5869
Is Sole Proprietor?:No
Enumeration Date:2011-06-29
Last Update Date:2015-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS016342207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102979431100001Medicaid
PA25-1754199OtherMULTIPLAN
PA2473406OtherCIGNA
PA25-1754199OtherDEVON
PA781164OtherUPMC
PA25-1754199OtherINTERGROUP
PA25-1754199OtherUNITED HEALTHCARE
PA25-1754199OtherVANTAGE
PA3061200OtherHIGHMARK
PAP01405258OtherRAILROAD MEDICARE
PA2473406OtherCIGNA