Individual
TRACY SANDFORD POSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
903 N 2ND ST, PHOENIX, AZ 85004-1906
(602) 416-7600
Mailing address
3825 W MENADOTA DR, GLENDALE, AZ 85308-7425
(602) 690-7479
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2503
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
WCLCJ70259
—
AZ
01
—
Z144795
MEDICARE PTAN
—
Enumeration date
08/24/2005
Last updated
08/04/2011
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