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Individual

DR. TRACY WILLIAMS MIDDLEBROOKS JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2315 CENTRAL AVE, AUGUSTA, GA 30904-6272
(706) 667-0070
(706) 667-0073
Mailing address
1505 WINTER ST, SUITE D, AUGUSTA, GA 30904
(706) 667-0070
(706) 667-0073

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
24986
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00266775A
GA
Enumeration date
09/29/2006
Last updated
02/25/2019
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