Provider Demographics
NPI:1699847632
Name:SAGER, ELIZABETH PEEBLES (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:PEEBLES
Last Name:SAGER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ELIZABETH
Other - Middle Name:LONGLEY
Other - Last Name:PEEBLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:797 BOULEVARD OF THE CHAMPIONS
Mailing Address - Street 2:
Mailing Address - City:SHALIMAR
Mailing Address - State:FL
Mailing Address - Zip Code:32579-2241
Mailing Address - Country:US
Mailing Address - Phone:937-241-1791
Mailing Address - Fax:
Practice Address - Street 1:307 BOATNER RD
Practice Address - Street 2:
Practice Address - City:EGLIN AFB
Practice Address - State:FL
Practice Address - Zip Code:32542-1302
Practice Address - Country:US
Practice Address - Phone:850-883-8505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.086676208200000X
OH35086676171000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No171000000XOther Service ProvidersMilitary Health Care Provider