Provider Demographics
NPI:1376579359
Name:CASE, ELIZABETH ANN (MD)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANN
Last Name:CASE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1221 S BROADWAY
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-2701
Mailing Address - Country:US
Mailing Address - Phone:859-258-6200
Mailing Address - Fax:859-258-6203
Practice Address - Street 1:160 N EAGLE CREEK DR STE 400
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-2124
Practice Address - Country:US
Practice Address - Phone:859-258-5220
Practice Address - Fax:859-258-5405
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01049482A207V00000X
KY36718207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000001619310OtherANTHEM PTAN
KY64034382Medicaid
IN200349610Medicaid
H41069Medicare UPIN
KYK011040Medicare PIN
KYK011042Medicare PIN