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Individual

MICHAEL D TRACY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
450 MOUNTAIN VIEW ST, POWELL, WY 82435-2212
(307) 754-7257
(307) 754-7217
Mailing address
449 MOUNTAIN VIEW ST, POWELL, WY 82435-2232
(307) 754-4559
(307) 754-7733

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
6739A
WY
208000000X
Pediatrics Physician
6739A
WY

Other

Enumeration date
10/13/2005
Last updated
11/05/2009
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