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Individual

TRACY R ORR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1380 E MEDICAL CENTER DR, ST GEORGE, UT 84790-2123
(435) 688-4000
Mailing address
560 W 800 N, OREM, UT 84057-3746
(810) 225-6246
(801) 225-1525

Taxonomy

Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
120040-1205
UT
2085D0003X
Diagnostic Neuroimaging (Radiology) Physician
0120040-1205
UT
2085R0202X
Diagnostic Radiology Physician
Primary
0120040-1205
UT
2085R0202X
Diagnostic Radiology Physician
11218
NV
2085R0204X
Vascular & Interventional Radiology Physician
0120040-1205
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01200408900001
BLUE CROSS
UT
01
107008873101
IHC
UT
05
870487570004
UT
01
870487570TRR
EMIA
UT
Enumeration date
07/19/2006
Last updated
09/25/2018
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