Basic Information
Provider Information
NPI: 1588954572
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SAVKO
FirstName: ELIZABETH
MiddleName: A
NamePrefix:  
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: BARLOW
OtherFirstName: ELIZABETH
OtherMiddleName: ANN
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: D.O.
OtherLastNameType: 1
Mailing Information
Address1: 250 N SHADELAND AVE
Address2: SUITE 130 - PROVIDER ENROLLMENT
City: INDIANAPOLIS
State: IN
PostalCode: 462194959
CountryCode: US
TelephoneNumber: 8144525105
FaxNumber: 3179624343
Practice Location
Address1: 1606 N 7TH ST
Address2:  
City: TERRE HAUTE
State: IN
PostalCode: 478042706
CountryCode: US
TelephoneNumber: 8122387523
FaxNumber: 8144525097
Other Information
ProviderEnumerationDate: 04/12/2011
LastUpdateDate: 01/23/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000XOT013105PAN Allopathic & Osteopathic PhysiciansEmergency Medicine 
207P00000X02004944AINY Allopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


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