Wimbush, Tracy Elizabeth

Wimbush, Tracy Elizabeth is an individual health care provider with primary practice located at 1240 Eagles Landing Pkwy Suite 300, Stockbridge GA 30281. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Pain Medicine. Allopathic & Osteopathic Physicians / Pain Medicine is her primary health care specialty. Wimbush, Tracy Elizabeth can be contacted via phone (770) 506-4350.

Contact Information

Primary practice address
1240 Eagles Landing Pkwy Suite 300 Stockbridge GA 30281
Phone: (770) 506-4350
Fax: (770) 506-9860
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 213411 Massachusetts
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 243910 New York
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X MD433123 Pennsylvania
Allopathic & Osteopathic Physicians / Pain Medicine 207LP2900X MD433123 Pennsylvania
Allopathic & Osteopathic Physicians / Pain Medicine 208VP0000X 068869 Georgia

Profile Details

NPI number 1780669739
LBN Legal business name Wimbush, Tracy Elizabeth
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 13th, 2005
Last updated Jun 3rd, 2014 - about 12 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 1780669739 NPPES
Georgia MEDICAID 003134595J
Georgia MEDICAID 2034247
Georgia Other 468709
Georgia Other J27108
Georgia MEDICAID 003134595K
Georgia MEDICAID 003134595L

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