Healthcare Provider Details

I. General information

NPI: 1205818630
Provider Name (Legal Business Name): TRACY L POPEY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2005
Last Update Date: 12/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 E MURPHY AVE
CONNELLSVILLE PA
15425-2724
US

IV. Provider business mailing address

401 E MURPHY AVE
CONNELLSVILLE PA
15425-2724
US

V. Phone/Fax

Practice location:
  • Phone: 724-626-2485
  • Fax: 724-626-2486
Mailing address:
  • Phone: 724-626-2485
  • Fax: 724-626-2486

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMD059795L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number35-06-5686-P
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code2083A0100X
TaxonomyAerospace Medicine Physician
License NumberMD059795L
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code2083A0100X
TaxonomyAerospace Medicine Physician
License Number35065686
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: