Healthcare Provider Details

I. General information

NPI: 1104930627
Provider Name (Legal Business Name): TRACY MICHAEL HARRINGTON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2006
Last Update Date: 10/18/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

930 20TH ST S SUITE 331
BIRMINGHAM AL
35205-2610
US

IV. Provider business mailing address

930 20TH ST S SUITE 331
BIRMINGHAM AL
35205-2610
US

V. Phone/Fax

Practice location:
  • Phone: 205-934-9700
  • Fax: 205-975-6962
Mailing address:
  • Phone: 205-934-9700
  • Fax: 205-975-6962

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number8603
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: