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General NPI Number Information
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NPI Number | 1013152594
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Entity Type | Individual
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Provider Name | CHRISTOPHER LEE TRACY MD
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Gender | Male
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Dates
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Enumeration Date | 12/11/2008
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Last Update Date | 12/14/2022
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Provider Practice Location Address
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Address Line | 4204 MURDOCKSVILLE RD
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City | WEST END
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State | NC
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Zip | 27376-8871
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Country | US
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Telephone | 910-255-0055
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Fax | 910-255-0060
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Provider Business Mailing Address
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Address Line | 4204 MURDOCKSVILLE RD
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City | WEST END
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State | NC
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Zip | 27376-8871
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Country | US
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Telephone | 910-255-0055
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Fax | 910-255-0060
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | MD15554
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 2008-00211
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License Number State | NC
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