Provider Demographics
NPI:1457807349
Name:FORWOOD, ELIZABETH WILSON (PA)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:WILSON
Last Name:FORWOOD
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:ANN
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:960 INDUSTRIAL PKWY STE B
Mailing Address - Street 2:
Mailing Address - City:SARALAND
Mailing Address - State:AL
Mailing Address - Zip Code:36571-3746
Mailing Address - Country:US
Mailing Address - Phone:251-414-5900
Mailing Address - Fax:251-445-8859
Practice Address - Street 1:960 INDUSTRIAL PKWY STE B
Practice Address - Street 2:
Practice Address - City:SARALAND
Practice Address - State:AL
Practice Address - Zip Code:36571-3746
Practice Address - Country:US
Practice Address - Phone:251-414-5900
Practice Address - Fax:251-445-8859
Is Sole Proprietor?:No
Enumeration Date:2016-08-30
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant