MEDICARE: DR. TRACY LYN ESKRA 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	207R00000X	Internal Medicine Physician	067916L	PA
2	207R00000X	Internal Medicine Physician	2010-01832	NC
3	207R00000X	Internal Medicine Physician	MD067916-L	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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558368522
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TRACY LYN ESKRA M.D.

Provider Business Mailing Address
First Line	:	2700 WAYNE MEMORIAL DR
Second Line	:
City	:	GOLDSBORO
State	:	NC
Zip	:	27534-9494
Country	:	US
Telephone Number	:	919-731-6462
Fax Number	:

Provider Business Practice Location Address
First Line	:	2700 WAYNE MEMORIAL DR
Second Line	:
City	:	GOLDSBORO
State	:	NC
Zip	:	27534-9494
Country	:	US
Telephone Number	:	919-731-6462
Fax Number	:

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

Provider Enumeration Date	:	07/05/2005
Last Update Date	:	05/04/2011

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