Individual
DR. TRACY MARIE BACIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.P.M
Contact information
Practice address
408 LAKE ST, ROSCOMMON, MI 48653-7663
(989) 275-3668
(989) 275-3338
Mailing address
PO BOX 949, ROSCOMMON, MI 48653
(989) 275-3668
(989) 275-3338
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
5901002138
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4857210410
BCBS PIN #
—
05
—
5198720
—
MI
Enumeration date
06/16/2006
Last updated
06/06/2019
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