Individual
DR. TRACY LYNNE SHAUB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
2ND FLOOR PARKS HALL, ATHENS, OH 45701
(740) 593-2516
(740) 593-2905
Mailing address
246 PARKS HALL, ATHENS, OH 45701-1359
(740) 593-2672
(740) 593-2905
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
34005750M
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0165922
—
OH
Enumeration date
02/07/2006
Last updated
10/05/2017
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