Provider Demographics
NPI:1982916995
Name:FLAX, ELIZABETH LYNN (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:LYNN
Last Name:FLAX
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ELIZABETH
Other - Middle Name:LYNN
Other - Last Name:WINK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:613 N 2ND ST
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72756-6611
Mailing Address - Country:US
Mailing Address - Phone:479-878-1060
Mailing Address - Fax:479-878-1070
Practice Address - Street 1:613 N 2ND ST
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72756-6611
Practice Address - Country:US
Practice Address - Phone:479-878-1060
Practice Address - Fax:479-878-1070
Is Sole Proprietor?:No
Enumeration Date:2010-07-07
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-40182207Q00000X
ARE7359207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS201177540AMedicaid