Individual
ELIZABETH A GARRETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3217 S PROVIDENCE RD, COLUMBIA, MO 65203-3639
(573) 884-8700
(573) 884-5604
Mailing address
PO BOX 7687, COLUMBIA, MO 65205-7687
(573) 882-2259
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
36165
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
102474
HEALTHLINK
MO
01
—
104136
UNITED HEALTHCARE
MO
01
—
13038
BLUE SHIELD/BLUE CHOICE
MO
01
—
2086331401
KANSAS MEDICAID
KS
Enumeration date
05/01/2006
Last updated
12/27/2007
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