Provider Demographics
NPI:1659343507
Name:ATKINSON, ELIZABETH SPROTT (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:SPROTT
Last Name:ATKINSON
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 1:1 INDEPENDENCE PT STE 212
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-4536
Mailing Address - Country:US
Mailing Address - Phone:864-797-6174
Mailing Address - Fax:
Practice Address - Street 1:701 GROVE RD FL 1
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605
Practice Address - Country:US
Practice Address - Phone:864-455-6185
Practice Address - Fax:864-455-5474
Is Sole Proprietor?:No
Enumeration Date:2006-02-06
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC27684207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCI140108510OtherMEDICARE PIN
SC20057402OtherSELECT HEALTH
SC276846Medicaid
NC5901751Medicaid
SCI140109068OtherMEDICARE PIN
SC189193OtherMEDCOST
SC1153Medicare PIN
SCI14010Medicare UPIN
NC5901751Medicaid