# ELIZABETH ROUSE WONG

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1891799847
- **Gender:** F
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 27435 | KY | Yes |

## Other

- **Enumeration date:** 06/08/2005
- **Last updated:** 03/21/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000479493 | ANTHEM - NCMA | — |
| 01 | — | 076693 | SIHO/NORTON | KY |
| 01 | — | 283734000 | PASSPORT ADVANTAGE/NORTON | KY |
| 01 | — | 50014617 | PASSPORT/NORTON | KY |
| 05 | — | 64274350 | — | KY |
| 01 | — | P00386070 | RAILROAD MEDICARE KY/NORT | KY |