1194387324 NPI number — DR. ELIZABETH NORA TOBENER AUD

Table of content: DR. ELIZABETH NORA TOBENER AUD (NPI 1194387324)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194387324 NPI number — DR. ELIZABETH NORA TOBENER AUD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TOBENER
Provider First Name:
ELIZABETH
Provider Middle Name:
NORA
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
AUD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1194387324
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/20/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
800 OAK RIDGE TURNPIKE
Provider Second Line Business Mailing Address:
SUITE C-100
Provider Business Mailing Address City Name:
OAK RIDGE
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37830-6927
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
865-483-2288
Provider Business Mailing Address Fax Number:
865-483-6568

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
800 OAK RIDGE TURNPIKE
Provider Second Line Business Practice Location Address:
SUITE C-100
Provider Business Practice Location Address City Name:
OAK RIDGE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37830-6927
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
865-483-2288
Provider Business Practice Location Address Fax Number:
865-483-6568
Provider Enumeration Date:
07/09/2019

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 237600000X , with the licence number:  AY2299 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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