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Individual
TRACY THOMAS PHILLIPS
Active
Individual
TRACY THOMAS PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
E1018
AR
208M00000X
Hospitalist Physician
E-1018
AR
261QP2300X
Primary Care Clinic/Center
E1018
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
129995003
—
AR
01
—
2Z0853
MEDICARE
AR
Enumeration date
07/12/2005
Last updated
05/29/2024
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