Provider Demographics
NPI:1548263783
Name:ATTIG, ELIZABETH ALTA (MD)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ALTA
Last Name:ATTIG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6080 N LA CHOLLA BLVD # 200
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85741-3533
Mailing Address - Country:US
Mailing Address - Phone:520-797-8550
Mailing Address - Fax:520-797-6986
Practice Address - Street 1:6080 N LA CHOLLA BLVD # 200
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85741-3533
Practice Address - Country:US
Practice Address - Phone:520-797-8550
Practice Address - Fax:520-797-6986
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2011-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ26935207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ167636-001OtherAZ PHYSICIANS IPA
AZ000521819OtherHUMANA
AZ25-00388OtherUNITED HEALTHCARE
AZ2591557OtherGHI
AZ409418OtherGREAT WEST
AZ10055684OtherPPO NEXT
AZ1Z1438OtherHEALTH NET
AZAZ0860270OtherBCBS OF ARIZONA
AZ005503156OtherCIGNA HEALTHCARE
AZ4087471OtherAETNA
AZ060057225OtherRAILROAD MEDICARE
AZ76766OtherCCN
AZ167636Medicaid
AZXPY185699OtherMEDI-CAL
AZ167636-001OtherAZ PHYSICIANS IPA
AZ1Z1438OtherHEALTH NET
AZ2591557OtherGHI
AZ25-00388OtherUNITED HEALTHCARE