Individual
DR. TRACEY F PETRIDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5779 GETWELL ROAD, BUILDING D, SUITE 3, SOUTHAVEN, MS 38672
(662) 510-6507
(662) 510-6508
Mailing address
5779 GETWELL ROAD, BUILDING D, SUITE 3, SOUTHAVEN, MS 38672
(662) 510-6507
(662) 510-6508
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
17839
MS
Other
Enumeration date
08/14/2007
Last updated
02/28/2012
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