Individual
MS. TRACY ALAINE GODFREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6151 N MAIN STREET RD, WEBB CITY, MO 64870-8189
(417) 781-0408
(417) 556-5377
Mailing address
6151 N MAIN STREET RD, WEBB CITY, MO 64870-8189
(417) 781-0408
(417) 556-5377
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
115438
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100179800A
—
OK
05
—
100405220D
—
KS
05
—
204685424
—
MO
Enumeration date
08/12/2005
Last updated
03/17/2016
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