Kennetz, Tracy Martig

Kennetz, Tracy Martig is an sole proprietor health care provider with primary practice located at 1423 N National Ave , Springfield MO 65802-2047. She recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as her primary health care specialty. Kennetz, Tracy Martig can be contacted via phone (417) 269-6583.

Contact Information

Primary practice address
1423 N National Ave Springfield MO 65802-2047
Phone: (417) 269-6583
Fax: (417) 269-6573
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 2001004533 Missouri
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X E-11413 Arkansas

Profile Details

NPI number 1790774362
LBN Legal business name Kennetz, Tracy Martig
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 17th, 2005
Last updated Oct 1st, 2018 - about 8 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 1790774362 NPPES
Missouri MEDICAID 205227101

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