Provider Demographics
NPI:1538133616
Name:WEISERT, ELIZABETH FRANCES (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:FRANCES
Last Name:WEISERT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5550 E HAMPTON ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-2919
Mailing Address - Country:US
Mailing Address - Phone:520-721-8605
Mailing Address - Fax:520-721-4209
Practice Address - Street 1:5550 E HAMPTON ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-2919
Practice Address - Country:US
Practice Address - Phone:520-721-8605
Practice Address - Fax:520-721-4209
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ27494207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ471540Medicaid
AZ471540Medicaid
G95440Medicare UPIN