IndividualActive
Elizabeth Haddock, PA-C
NPI 1376036616 · Physician Assistant · Tishomingo, OK
Provider details
- NPI number
- 1376036616
- Entity type
- Individual
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- License
- 2817 (OK)
Practice location
1000 S Byrd St
Tishomingo, OK 73460
Phone: (580) 371-2327
Fax: (580) 371-2127
Mailing address
1000 S Byrd St
Tishomingo, OK 73460-3265
Registry dates
- Enumerated
- 2018-06-12
- Last updated
- 2018-07-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.