Tracy D. Mickelsen in Meridian - Surgical
Tracy D. Mickelsen - NPI 1801073655
Tracy D. Mickelsen is a Surgical in Meridian, Idaho. Tracy D. Mickelsen practices all healthcare services and medical treatments related to Surgical. The NPI Number for Tracy D. Mickelsen is 1801073655. The last update date is 2017-12-07.
Tracy D. Mickelsen's current location address is 3015 E Magic View Dr, Meridian, Idaho. You can contact this provider via phone number 2088552410 and fax number 2084825515. The mailing address for Tracy D. Mickelsen is 3015 E Magic View Dr, Meridian, Idaho. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Tracy D. Mickelsen |
|---|---|
| Address | 3015 E Magic View Dr, Meridian, Idaho |
| Phone Number | 2088552410 |
| Fax Number | 2084825515 |
| Sole Proprietor | Y |
| Credentials | CSFA |
NPI Number Detail
| NPI Number | 1801073655 |
|---|---|
| Provider Enumeration Date | 2008-01-23 |
| Last Updated Date | 2017-12-07 |
Provider Mailing Address Detail
| Address | 3015 E Magic View Dr |
|---|---|
| City | Meridian |
| State | Idaho (ID) |
| Post Code | 836423743 |
| Phone Number | 2088552410 |
| Fax Number | 2084825515 |
Provider's Primary Taxonomy Detail
| Speciality | Surgical |
|---|---|
| Taxonomy | 363As0400X |
| Licence No | 178692 |
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Definition: A licensed healthcare professional who assists in providing surgical care under physician supervision. |
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What is the unique provider identifier assigned to Tracy D. Mickelsen?
The Tracy D. Mickelsen has been issued the NPI (National Provider Identifier) 1801073655 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you please provide the complete physical location address of Tracy D. Mickelsen?
The Tracy D. Mickelsen is physically situated at 3015 E Magic View Dr, in the city of Meridian, state of ID, with the postal code 836423743.
What is Tracy D. Mickelsen's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Tracy D. Mickelsen's specialized field of practice is Surgical, and the corresponding taxonomy code that categorizes this area of specialization is 363As0400X.
On what date did the Centers for Medicare & Medicaid Services assign the 1801073655 to Tracy D. Mickelsen?
The Centers for Medicare & Medicaid Services assigned the 1801073655 to Tracy D. Mickelsen on 2008-01-23.
When was the information regarding Tracy D. Mickelsen most recently updated?
The details pertaining to the Tracy D. Mickelsen, including its address, specialty, and other relevant information, were last refreshed on 2017-12-07.
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