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TRACY L SLOCUM FARRITOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
555 S 70TH ST, LINCOLN, NE 68510-2462
(402) 219-8747
(402) 219-8748
Mailing address
555 S 70TH ST, LINCOLN, NE 68510-2462
(402) 421-0896
(402) 421-0945

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
20562
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
04399
BCBS
NE
05
0587493
IA
05
100380190A
KS
01
10422
MIDLANDS CHOICE
05
470780857 23
NE
01
76-00114
UHC
NE
Enumeration date
08/09/2006
Last updated
01/27/2021
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