MEDICARE: TRACY M REED, DPM,LLC

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	261QP1100X	Podiatric Clinic/Center	000797	MO

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	:	1538384300
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRACY M REED, DPM,LLC

Provider Business Mailing Address
First Line	:	5937 W FLORISSANT AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63136-4952
Country	:	US
Telephone Number	:	314-381-2224
Fax Number	:	314-381-1771

Provider Business Practice Location Address
First Line	:	5937 W FLORISSANT AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63136-4952
Country	:	US
Telephone Number	:	314-381-2224
Fax Number	:	314-381-1771

Authorized Official
Title or Position	:	OWNER
Name	:	DR. TRACY MARIA REED
Credential	:	DPM
Telephone Number	:	314-381-2224

Provider Enumeration Date	:	04/16/2007
Last Update Date	:	11/10/2008

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