Healthcare Provider Details

I. General information

NPI: 1013930759
Provider Name (Legal Business Name): TRACI JO WESTERFIELD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 01/16/2025
Certification Date: 01/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 E 9TH ST
OWENSBORO KY
42303-0337
US

IV. Provider business mailing address

1300 E 9TH ST
OWENSBORO KY
42303-0337
US

V. Phone/Fax

Practice location:
  • Phone: 859-421-1806
  • Fax:
Mailing address:
  • Phone: 270-297-7332
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number33224
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code2083A0300X
TaxonomyAddiction Medicine (Preventive Medicine) Physician
License Number33224
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: