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Individual

ELIZABETH S STIVERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
908 WALLACE AVE, SUITE 108, LEITCHFIELD, KY 42754-1479
(270) 259-5641
(270) 259-5309
Mailing address
908 WALLACE AVE, SUITE 108, LEITCHFIELD, KY 42754-1479
(270) 259-5641
(270) 259-5309

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
50135
KY
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100360200
KY
Enumeration date
03/27/2014
Last updated
05/11/2017
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