Provider Demographics
NPI:1588822050
Name:PALMER, ELIZABETH BREZINA (MD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:BREZINA
Last Name:PALMER
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:999 EXECUTIVE PARK BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37660-4632
Mailing Address - Country:US
Mailing Address - Phone:423-224-3250
Mailing Address - Fax:423-224-3258
Practice Address - Street 1:2103 FOREST DR
Practice Address - Street 2:SUITE 5
Practice Address - City:GRAY
Practice Address - State:TN
Practice Address - Zip Code:37615-8422
Practice Address - Country:US
Practice Address - Phone:423-477-2885
Practice Address - Fax:423-477-0113
Is Sole Proprietor?:No
Enumeration Date:2008-05-30
Last Update Date:2012-07-20
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Provider Licenses
StateLicense IDTaxonomies
TN46901207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN103I082852Medicare PIN
TN103I080547Medicare PIN