Garcia, Elisa Boma

Garcia, Elisa Boma is an individual health care provider with primary practice located at 1237 Woodland Dr , Elizabethtown KY 42701-2709. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Neurology. Allopathic & Osteopathic Physicians / Neurology is her primary health care specialty. Garcia, Elisa Boma can be contacted via phone (270) 769-6875.

Contact Information

Primary practice address
1237 Woodland Dr Elizabethtown KY 42701-2709
Phone: (270) 769-6875
Fax: (270) 737-9696
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 20007 Kentucky
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 20007 Kentucky

Profile Details

NPI number 1700831781
LBN Legal business name Garcia, Elisa Boma
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date May 24th, 2006
Last updated Jun 30th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1700831781 NPPES
Other 000000050918 ANTHEM BCBS
Other 1050021 ANTHEM BCBS
Other 130012244 ANTHEM BCBS
MEDICAID 64200014 ANTHEM BCBS
Other 2432753000 ANTHEM BCBS

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