Mountcastle, Elizabeth Ann

Mountcastle, Elizabeth Ann is an individual health care provider with primary practice located at 286 Mitylene Park Dr , Montgomery AL 36117-3548. She recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as her primary health care specialty. Mountcastle, Elizabeth Ann can be contacted via phone (334) 396-1555.

Contact Information

Primary practice address
286 Mitylene Park Dr Montgomery AL 36117-3548
Phone: (334) 396-1555
Fax: (334) 396-9833
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 00009695 Alabama

Profile Details

NPI number 1114037215
LBN Legal business name Mountcastle, Elizabeth Ann
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 30th, 2006
Last updated Jan 9th, 2013 - about 12 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 1114037215 NPPES
Alabama Other 631066099 TAX#
Alabama Other 510-82148 TAX#
Alabama Other 511-30221 TAX#
Alabama Other 45-3970660 TAX#
Alabama Other CM4358 TAX#
Alabama MEDICAID 528501290 TAX#

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