Healthcare Provider Details

I. General information

NPI: 1083662449
Provider Name (Legal Business Name): TRACY A MACEACHERN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1650 COCHRANE CIR UNIT MEDDAC
FORT CARSON CO
80913-4604
US

IV. Provider business mailing address

1241 W MINERAL AVE SUITE 100
LITTLETON CO
80120-5685
US

V. Phone/Fax

Practice location:
  • Phone: 719-526-5231
  • Fax:
Mailing address:
  • Phone: 303-759-0854
  • Fax: 303-759-0864

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number38671
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: