Individual
ELIZABETH C RILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
529 S JACKSON ST, LOUISVILLE, KY 40202-3229
(502) 562-4358
(502) 562-6811
Mailing address
529 S JACKSON ST, LOUISVILLE, KY 40202-3229
(502) 562-4358
(502) 562-6811
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
220429
MA
207RH0003X
Hematology & Oncology Physician
Primary
43332
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50027776
PASSPORT HEALTH PLAN
KY
05
—
7100113260
—
KY
Enumeration date
11/16/2006
Last updated
08/31/2010
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