Individual
ELIZABETH JANE FOGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
208 OLD MOCKSVILLE RD, STATESVILLE, NC 28625-1953
(704) 838-8237
(704) 924-5358
Mailing address
PO BOX 1845, STATESVILLE, NC 28687-1845
(704) 873-4277
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-14461
NC
Other
Enumeration date
01/04/2024
Last updated
08/19/2024
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