Godfrey, Tracy Alaine

Godfrey, Tracy Alaine is an individual health care provider with primary practice located at 6151 N Main Street Rd , Webb City MO 64870-8189. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Godfrey, Tracy Alaine can be contacted via phone (417) 781-0408.

Contact Information

Primary practice address
6151 N Main Street Rd Webb City MO 64870-8189
Phone: (417) 781-0408
Fax: (417) 556-5377
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 115438 Missouri

Profile Details

NPI number 1104828714
LBN Legal business name Godfrey, Tracy Alaine
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 12th, 2005
Last updated Mar 17th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104828714 NPPES
Oklahoma MEDICAID 100179800A
Oklahoma MEDICAID 100405220D
Oklahoma MEDICAID 204685424

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