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Contact Information

ELIZABETH A JACK, MD
1600 MEDICAL PKWY
CARSON CITY, NV89703-4625
 Phone: 775-445-8502
 Fax: 775-888-4448
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Anatomic Pathology & Clinical Pathology

207ZP0102X 22 Physician/Pathology
Indicates primary specialty

NPI Profile & details for ELIZABETH A JACK · (Female)

NPI Number 1538230545
Status Active
Credentials MD
Entity Individual
Enumeration date 11/13/2006
Last updated 12/18/2018 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • NV License # 5089
  • NV Medicaid 1538230545
Hospital affiliation(s)
  • CARSON TAHOE REGIONAL MEDICAL CENTER - (Acute Care)
    1600 MEDICAL PARKWAY
    CARSON CITY, NV 89703
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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