Provider Demographics
NPI:1306594361
Name:WARD-RACY, ELIZABETH ANN X (MD)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:ANN
Last Name:WARD-RACY
Suffix:X
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:ANN
Other - Last Name:WARD-RACY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DR WARD-RACY
Mailing Address - Street 1:1511 E ENTRADA SEXTA
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718-5826
Mailing Address - Country:US
Mailing Address - Phone:520-299-1421
Mailing Address - Fax:
Practice Address - Street 1:1511 E ENTRADA SEXTA
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85718-5826
Practice Address - Country:US
Practice Address - Phone:520-299-1421
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-17
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ107452084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry