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Individual

DR. TRACY YOUNG ROTH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1601 CENTER ST, STE 3S, MOBILE, AL 36604-1512
(251) 415-1496
(251) 415-1450
Mailing address
PO BOX 40480, MOBILE, AL 36640-0480
(251) 415-1496
(251) 415-1450

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
14783
MS
207V00000X
Obstetrics & Gynecology Physician
Primary
19526
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
009912195
AL
05
0116740
MS
Enumeration date
10/11/2012
Last updated
02/20/2017
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