# DR. TRACY PRINCE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1053335307
- **Gender:** Man
- **Credential:** D.O.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | OS010945L | PA | Yes |

## Other

- **Enumeration date:** 07/27/2006
- **Last updated:** 03/17/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0019165970004 | — | PA |
| 01 | — | 1386391 | HIGHMARK BS | PA |
| 01 | — | 2525814 | CIGNA | PA |
| 01 | — | 50097247 | CAPITAL BC | PA |
| 01 | — | 7989331 | AETNA | PA |
| 01 | — | P010738 | GATEWAY HEALTH PLAN | PA |