Organization
SENIOR MEDICAL CORP. P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAYMOND D TRACY D.O. (MEDICAL DIRECTOR)
(231) 854-2999
Entity
Organization
Contact information
Practice address
3944 S BRENLOR DR, HESPERIA, MI 49421-9585
(231) 854-2999
(231) 854-2998
Mailing address
6087 E FILMORE RD, WALKERVILLE, MI 49459-9344
(231) 854-7655
(231) 854-2998
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
RT007455
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4260509
—
MI
01
—
P00232094
RAIL ROAD MEDICARE
MI
01
—
P00449750
RAIL ROAD MEDICARE
MI
01
—
P00694735
RAIL ROAD MEDICARE
MI
Enumeration date
10/25/2006
Last updated
02/13/2012
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