Provider Demographics
NPI:1124084306
Name:MATHEWS, ELIZABETH G (MD)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:G
Last Name:MATHEWS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:JAMES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2727 W FRYE RD
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-4941
Mailing Address - Country:US
Mailing Address - Phone:423-473-5027
Mailing Address - Fax:
Practice Address - Street 1:2727 W FRYE RD
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-4941
Practice Address - Country:US
Practice Address - Phone:423-473-5027
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2010-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ33669207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ914160Medicaid
AZH62920Medicare UPIN
AZZ110704Medicare PIN