Individual
TRACY E MADSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 519-1604
(401) 272-0538
Mailing address
PO BOX 9484, PROVIDENCE, RI 02940-9484
(401) 854-2500
(401) 854-2519
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
042.0018047
VT
207P00000X
Emergency Medicine Physician
LP01357
RI
207P00000X
Emergency Medicine Physician
MD13932
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07/12/12
NHPRI
RI
01
—
07/22/2012
BCBS
RI
01
—
08/10/2012
HEALTHNET FED SERVICES
RI
01
—
08/21/2012
TUFTS HEALTH PLAN
RI
05
—
110093030A
—
MA
05
—
TM89202
—
RI
Enumeration date
06/25/2008
Last updated
09/26/2024
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