Healthcare Provider Details

I. General information

NPI: 1023085602
Provider Name (Legal Business Name): TRACY MORRISON PARKS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS TRACY KAREN MORRISON

II. Dates (important events)

Enumeration Date: 03/02/2006
Last Update Date: 11/07/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

586 MORRIS MAJESTIC RD
MORRIS AL
35116-1245
US

IV. Provider business mailing address

586 MORRIS MAJESTIC RD
MORRIS AL
35116-1245
US

V. Phone/Fax

Practice location:
  • Phone: 205-933-4242
  • Fax: 205-647-0561
Mailing address:
  • Phone: 205-933-4242
  • Fax: 205-647-0561

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number00017426
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: