MEDICARE: DR. TRACY JO GEMMELL MD

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	207V00000X	Obstetrics & Gynecology Physician	MD060368L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1427083872
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TRACY JO GEMMELL MD

Provider Business Mailing Address
First Line	:	911 LIGONIER STREET
Second Line	:	STE 205
City	:	LATROBE
State	:	PA
Zip	:	15650
Country	:	US
Telephone Number	:	724-532-2322
Fax Number	:	724-532-2405

Provider Business Practice Location Address
First Line	:	841 HOSPITAL RD STE 2500
Second Line	:
City	:	INDIANA
State	:	PA
Zip	:	15701-3699
Country	:	US
Telephone Number	:	724-427-2797
Fax Number	:	724-427-2715

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

Provider Enumeration Date	:	07/12/2006
Last Update Date	:	03/26/2021

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