Organization
TRACY MIDDLEBROOKS, MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY MIDDLEBROOKS MD (OWNER)
(706) 667-0070
Entity
Organization
Contact information
Practice address
2315 CENTRAL AVE, AUGUSTA, GA 30904-6272
(706) 667-0070
Mailing address
2315 CENTRAL AVE, AUGUSTA, GA 30904-6272
(706) 667-0070
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
021986
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000266725A
—
GA
Enumeration date
11/19/2012
Last updated
11/19/2012
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