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Individual

DR. TRACY SMITH MAYBERRY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DPM

Contact information

Practice address
1683 WASHINGTON RD, EAST POINT, GA 30344-4265
(404) 766-6400
(404) 766-6450
Mailing address
1683 WASHINGTON ROAD, EAST POINT, GA 30344-4265
(404) 766-6400
(404) 766-6450

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
000763
GA
213EP1101X
Primary Podiatric Medicine Podiatrist
POD000763
GA
213ER0200X
Radiology Podiatrist
POD000763
GA
213ES0000X
Sports Medicine Podiatrist
POD000763
GA
213ES0103X
Foot & Ankle Surgery Podiatrist
POD000763
GA
213ES0131X
Foot Surgery Podiatrist
POD000763
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000672119F
GA
01
480028687
RAILROAD MEDICARE
GA
Enumeration date
11/23/2005
Last updated
02/08/2021
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