Provider Demographics
NPI:1487799706
Name:LUXFORD, BETSY (MD)
Entity type:Individual
Prefix:DR
First Name:BETSY
Middle Name:
Last Name:LUXFORD
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 1:100 CORRECTIONS DRIVE
Mailing Address - Street 2:ATTN HSU
Mailing Address - City:STANLEY
Mailing Address - State:WI
Mailing Address - Zip Code:54768-6500
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:100 CORRECTIONS DR
Practice Address - Street 2:ATTN HSU
Practice Address - City:STANLEY
Practice Address - State:WI
Practice Address - Zip Code:54768-6500
Practice Address - Country:US
Practice Address - Phone:715-644-3764
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI34002-0202084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry