# ELIZABETH S. MATEOS-TIONGCO

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093099012
- **Authorized official:** DR. ELIZABETH SANCHEZ MATEOS M.D. (OWNER)
- **Authorized official phone:** (812) 659-2030

## Contact information

- **Practice address:** 195 E BROAD ST, LYONS, IN 47443-9502
- **Practice address phone:** (812) 659-2030
- **Practice address fax:** (812) 659-7601
- **Mailing address:** PO BOX 236, LYONS, IN 47443-0236
- **Mailing address phone:** (812) 659-2030
- **Mailing address fax:** (812) 659-7601

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | 01033055A | IN | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | 01033055B | IN | — |

## Other

- **Enumeration date:** 10/10/2011
- **Last updated:** 10/10/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000084916 | BCBS | IN |
| 05 | — | 100124750A | — | IN |
| 01 | — | 160025634 | RAILROAD MED | IN |
| 01 | — | 1790783637 | COMMERICAL | IN |