Basic Information
| Provider Information | |||||||||
| NPI: | 1548263783 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ATTIG | ||||||||
| FirstName: | ELIZABETH | ||||||||
| MiddleName: | ALTA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6080 N LA CHOLLA BLVD # 200 | ||||||||
| Address2: | |||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857413533 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5207978550 | ||||||||
| FaxNumber: | 5207976986 | ||||||||
| Practice Location | |||||||||
| Address1: | 6080 N LA CHOLLA BLVD # 200 | ||||||||
| Address2: | |||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857413533 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5207978550 | ||||||||
| FaxNumber: | 5207976986 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/23/2005 | ||||||||
| LastUpdateDate: | 10/24/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | 26935 | AZ | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
ID Information
| ID | Type | State | Issuer | Description | 167636-001 | 01 | AZ | AZ PHYSICIANS IPA | OTHER | 000521819 | 01 | AZ | HUMANA | OTHER | 25-00388 | 01 | AZ | UNITED HEALTHCARE | OTHER | 2591557 | 01 | AZ | GHI | OTHER | 409418 | 01 | AZ | GREAT WEST | OTHER | 10055684 | 01 | AZ | PPO NEXT | OTHER | 1Z1438 | 01 | AZ | HEALTH NET | OTHER | AZ0860270 | 01 | AZ | BCBS OF ARIZONA | OTHER | 005503156 | 01 | AZ | CIGNA HEALTHCARE | OTHER | 4087471 | 01 | AZ | AETNA | OTHER | 060057225 | 01 | AZ | RAILROAD MEDICARE | OTHER | 76766 | 01 | AZ | CCN | OTHER | 167636 | 05 | AZ | MEDICAID | XPY185699 | 01 | AZ | MEDI-CAL | OTHER |