Individual
ELIZABETH WHITNEY SUTLIFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
910 E HOUSTON ST STE 270, TYLER, TX 75702
(903) 606-4300
Mailing address
PO BOX 846098, DALLAS, TX 75284-6098
(903) 324-6400
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
P4828
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
322265501
—
TX
01
—
322265502
MEDICAID CSHCN
TX
05
—
322265503
—
TX
Enumeration date
07/18/2007
Last updated
04/09/2020
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