Provider Demographics
NPI:1407807761
Name:LAROCHE, ELIZABETH READ (MD)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:READ
Last Name:LAROCHE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 UPTOWN SQ
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-0574
Mailing Address - Country:US
Mailing Address - Phone:615-904-1650
Mailing Address - Fax:615-904-0598
Practice Address - Street 1:305 UPTOWN SQ
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-0574
Practice Address - Country:US
Practice Address - Phone:615-904-1650
Practice Address - Fax:615-904-0598
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-12
Last Update Date:2011-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN15608174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNA97256Medicare UPIN
TN3842072Medicare ID - Type UnspecifiedMEDICARE ID NUMBER