Dr Elizabeth Justine Nourse, MD is a medicare enrolled "Dermatology" physician in Fairborn, Ohio. Her current practice location is
725 University Blvd, Fairborn, Ohio. You can reach out to her office (for appointments etc.) via phone at
(937) 245-7200.
Dr Elizabeth Justine Nourse is licensed to practice in Ohio (license number 57.253352) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1952975344.
Physician's Profile
Full Name | Dr Elizabeth Justine Nourse |
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Gender | Female |
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Speciality | Dermatology |
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Location | 725 University Blvd, Fairborn, Ohio |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1952975344
- Provider Enumeration Date: 05/19/2021
- Last Update Date: 04/21/2025
Medicare PECOS Information:
- PECOS PAC ID: 0042690018
- Enrollment ID: I20220707003997
Medical Identifiers
Medical identifiers for Dr Elizabeth Justine Nourse such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1952975344 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
208000000X | Pediatrics | 57.253352 (Ohio) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
207N00000X | Dermatology | 57.253352 (Ohio) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Elizabeth Justine Nourse is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Dr Elizabeth Justine Nourse, MD 744 Mohawk St, Columbus, OH 43206-2111 Ph: (260) 450-8784 | Dr Elizabeth Justine Nourse, MD 725 University Blvd, Fairborn, OH 45324 Ph: (937) 245-7200 |
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