Individual
MICHAEL TRACEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, FAAD
Contact information
Practice address
4301 WILSON ST, FORT SILL, OK 73503-4472
(833) 286-3732
Mailing address
4301 WILSON ST, LAWTON, OK 73503-4472
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
0101267699
VA
207N00000X
Dermatology Physician
41401
OK
Other
Enumeration date
04/17/2018
Last updated
01/02/2024
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