Tracy Family Practice Clinic Pa in De Witt - Preferred Provider Organization
Tracy Family Practice Clinic Pa - NPI 1659319150
Tracy Family Practice Clinic Pa is a Preferred Provider Organization in De Witt, Arkansas. Tracy Family Practice Clinic Pa practices all healthcare services and medical treatments related to Preferred Provider Organization. The NPI Number for Tracy Family Practice Clinic Pa is 1659319150. The last update date is 2010-09-16.
Tracy Family Practice Clinic Pa's current location address is 1940 S Whitehead Dr, De Witt, Arkansas. You can contact this provider via phone number 8709464505 and fax number 8709462428. The mailing address for Tracy Family Practice Clinic Pa is 1940 S Whitehead Dr, De Witt, Arkansas. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Tracy Family Practice Clinic Pa |
|---|---|
| Address | 1940 S Whitehead Dr, De Witt, Arkansas |
| Phone Number | 8709464505 |
| Fax Number | 8709462428 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | OWNER |
|---|---|
| Authorized Official Name | Tracy Lee Wallace |
| Credentials | M.D. |
| Telephone Number | 8709464505 |
NPI Number Detail
| NPI Number | 1659319150 |
|---|---|
| Provider Enumeration Date | 2006-06-04 |
| Last Updated Date | 2010-09-16 |
Provider Mailing Address Detail
| Address | 1940 S Whitehead Dr |
|---|---|
| City | De Witt |
| State | Arkansas (AR) |
| Post Code | 720422906 |
| Phone Number | 8709464505 |
| Fax Number | 8709462428 |
Provider's Primary Taxonomy Detail
| Speciality | Preferred Provider Organization |
|---|---|
| Taxonomy | 305R00000X |
| Licence No | C7340 |
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Definition: A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient rec |
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What is the unique identifier code issued to Tracy Family Practice Clinic Pa by the Centers for Medicare & Medicaid Services?
The Tracy Family Practice Clinic Pa has been assigned the NPI (National Provider Identifier) 1659319150. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Can you provide the Tracy Family Practice Clinic Pa's physical address?
The Tracy Family Practice Clinic Pa is physically located at 1940 S Whitehead Dr, in the city of De Witt, AR, with the postal code 720422906.
What is Tracy Family Practice Clinic Pa's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Tracy Family Practice Clinic Pa is Preferred Provider Organization, and the taxonomy code that categorizes this field of expertise is 305R00000X.
On what date did the Centers for Medicare & Medicaid Services issue the 1659319150 to Tracy Family Practice Clinic Pa?
The Tracy Family Practice Clinic Pa received its 1659319150 assignment from the Centers for Medicare & Medicaid Services on 2006-06-04.
As of what date were the details related to Tracy Family Practice Clinic Pa most recently updated or revised?
The information pertaining to Tracy Family Practice Clinic Pa, including its address, specialty, and other relevant details, was last updated or revised on 2010-09-16.