Individual
DR. KEVIN PATRICK TRACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1770 SKYLYN DR, SPARTANBURG, SC 29307-1045
(864) 582-7892
(864) 582-1582
Mailing address
PO BOX 277827, ATLANTA, GA 30384-7827
(864) 253-8080
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
14815
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
148156
—
SC
01
—
P00386917
MEDICARE RAILROAD
SC
Enumeration date
04/20/2006
Last updated
11/03/2008
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