Individual
DR. TRACIE L OVERBECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD, PHD
Contact information
Practice address
166 PASADENA DRIVE SUITE 150, LEXINGTON, KY 40503-2938
(859) 276-1452
(859) 277-1237
Mailing address
DEPT. 453 PO BOX 1000, MEMPHIS, TN 38148-0001
(828) 575-2625
(828) 350-2174
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
40012
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64086788
—
KY
01
—
K092670
MEDICARE PTAN
KY
Enumeration date
04/14/2006
Last updated
10/30/2023
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