Provider Demographics
NPI:1306155262
Name:ELIZABETH CROW MD, LLC
Entity type:Organization
Organization Name:ELIZABETH CROW MD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:A
Authorized Official - Last Name:CROW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:907-562-2965
Mailing Address - Street 1:129 E 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99501-3607
Mailing Address - Country:US
Mailing Address - Phone:907-562-2965
Mailing Address - Fax:907-561-1257
Practice Address - Street 1:129 E 7TH AVE
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99501-3607
Practice Address - Country:US
Practice Address - Phone:907-562-2965
Practice Address - Fax:907-561-1257
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-27
Last Update Date:2011-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK4533207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMD1295Medicaid