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Individual
ELIZA ERVIN FULTON THORNTON
Active
Individual
ELIZA ERVIN FULTON THORNTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
MD436674
PA
207QA0505X
Adult Medicine Physician
Primary
MD436674
PA
390200000X
Student in an Organized Health Care Education/Training Program
MT188666
PA
Other
Enumeration date
10/08/2008
Last updated
06/28/2026
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