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Organization

ELIZABETH S. MATEOS-TIONGCO

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ELIZABETH SANCHEZ MATEOS M.D. (OWNER)
(812) 659-2030
Entity
Organization

Contact information

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

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
01033055A
IN
207V00000X
Obstetrics & Gynecology Physician
01033055B
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000084916
BCBS
IN
05
100124750A
IN
01
160025634
RAILROAD MED
IN
01
1790783637
COMMERICAL
IN
Enumeration date
10/10/2011
Last updated
10/10/2011
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