MEDICARE: TRACY MICHAEL HARRINGTON M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	8603	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0110894	OTHER		UNITEDHEALTHCARE

General Provider Information

NPI Number	:	1104930627
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRACY MICHAEL HARRINGTON M.D.

Provider Business Mailing Address
First Line	:	930 20TH ST S
Second Line	:	SUITE 331
City	:	BIRMINGHAM
State	:	AL
Zip	:	35205-2610
Country	:	US
Telephone Number	:	205-934-9700
Fax Number	:	205-975-6962

Provider Business Practice Location Address
First Line	:	930 20TH ST S
Second Line	:	SUITE 331
City	:	BIRMINGHAM
State	:	AL
Zip	:	35205-2610
Country	:	US
Telephone Number	:	205-934-9700
Fax Number	:	205-975-6962

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/19/2006
Last Update Date	:	10/18/2007

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