Tyson, Tracy
Tyson, Tracy is an individual health care provider with primary practice located at 11 Crest Rd , Saint Albans VT 05478-9701. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is her primary health care specialty. Tyson, Tracy can be contacted via phone (802) 527-8189.Contact Information
Primary practice address
11 Crest Rd
Saint Albans VT 05478-9701
Phone: (802) 527-8189
Fax: (802) 527-8187
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine | 207PP0204X | ME96031 | Florida |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | ME96031 | Florida |
Profile Details
| NPI number | 1205865045 |
|---|---|
| LBN Legal business name | Tyson, Tracy |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 2nd, 2006 |
| Last updated | Jun 30th, 2023 - about 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1205865045 | NPPES |
| Florida | MEDICAID | 275570000 | |
| Florida | Other | 57012 | |
| Florida | MEDICAID | 202194472A |
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