Provider Demographics
NPI:1306801980
Name:BURNSIDE ROLLINS, ELIZABETH S (MD MPH MS)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:S
Last Name:BURNSIDE ROLLINS
Suffix:
Gender:F
Credentials:MD MPH MS
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:S
Other - Last Name:BURNSIDE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD MPH MS
Mailing Address - Street 1:917 HIDDEN CAVE RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53717-2759
Mailing Address - Country:US
Mailing Address - Phone:608-658-7925
Mailing Address - Fax:
Practice Address - Street 1:600 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53792
Practice Address - Country:US
Practice Address - Phone:608-263-8340
Practice Address - Fax:608-265-6533
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI433492085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology