Provider Demographics
NPI:1245289636
Name:CARVILL, ELIZABETH KATE (PAA)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:KATE
Last Name:CARVILL
Suffix:
Gender:F
Credentials:PAA
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:K
Other - Last Name:BELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PAA
Mailing Address - Street 1:1001 JOHNSON FERRY RD
Mailing Address - Street 2:SCOTTISH RITE DEPT OF ANES
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342
Mailing Address - Country:US
Mailing Address - Phone:404-785-5932
Mailing Address - Fax:404-785-7977
Practice Address - Street 1:1001 JOHNSON FERRY RD
Practice Address - Street 2:SCOTTISH RITE DEPT OF ANES
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342
Practice Address - Country:US
Practice Address - Phone:404-785-5932
Practice Address - Fax:404-785-7977
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2008-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA004585367H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA769752045Medicaid