Individual
TRACY M FITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1 SOUTHTOWNE DR, POTOSI, MO 63664-5729
(573) 438-9355
Mailing address
1 SOUTHTOWNE DR, POTOSI, MO 63664-5729
(573) 438-9355
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2009022062
MO
207Q00000X
Family Medicine Physician
E5248
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
165595001
—
AR
01
—
431560263
TRICARE
MO
01
—
P00464657
RAILROAD MEDICARE
AR
01
—
P01027294
RR MCR
MO
Enumeration date
03/15/2007
Last updated
04/14/2015
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