Elizabeth G Tice DPM PLLC

Primary specialty

PodiatristTaxonomy code 213E00000X

License

80188 Issued in MS

Legal business name

ELIZABETH G TICE DPM PLLC

Practice address

1860 Chadwick Drive
Suite 106
Jackson, MS 39204

Phone

(601) 376-2963

Fax

(601) 376-2967

NPI assigned

Apr 22, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Elizabeth G Tice, DPM

Title

Physician/Owner

Phone

(601) 376-2963

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1208822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408492800000",
    "number": "1245404185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 CHADWICK DRIVE",
            "address_2": "SUITE 106",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39204",
            "telephone_number": "601-376-2963",
            "fax_number": "601-376-2967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1860 CHADWICK DRIVE",
            "address_2": "SUITE 106",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39204",
            "telephone_number": "601-376-2963",
            "fax_number": "601-376-2967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELIZABETH G TICE DPM PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-22",
        "last_updated": "2014-08-20",
        "status": "A",
        "authorized_official_last_name": "TICE",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "601-376-2963",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "MS",
            "license": "80188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Podiatrist in Jackson, MS
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• Podiatrist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.