Organization
ELIZABETH G TICE DPM PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH G TICE DPM (PHYSICIAN/OWNER)
(601) 376-2963
Entity
Organization
Contact information
Practice address
1860 CHADWICK DRIVE, SUITE 106, JACKSON, MS 39204
(601) 376-2963
(601) 376-2967
Mailing address
1860 CHADWICK DRIVE, SUITE 106, JACKSON, MS 39204
(601) 376-2963
(601) 376-2967
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
80188
MS
Other
Enumeration date
04/22/2008
Last updated
08/20/2014
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