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Individual
DR. TRACY SMITH MAYBERRY
Active
Individual
DR. TRACY SMITH MAYBERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
000763
GA
213EP1101X
Primary Podiatric Medicine Podiatrist
POD000763
GA
213ER0200X
Radiology Podiatrist
POD000763
GA
213ES0000X
Sports Medicine Podiatrist
POD000763
GA
213ES0103X
Foot & Ankle Surgery Podiatrist
POD000763
GA
213ES0131X
Foot Surgery Podiatrist
POD000763
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000672119F
—
GA
01
—
480028687
RAILROAD MEDICARE
GA
Enumeration date
11/23/2005
Last updated
02/08/2021
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