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General NPI Number Information
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NPI Number | 1033430814
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Entity Type | Individual
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Provider Name | TRACY LYNN CHASON MD
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Gender | Female
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Dates
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Enumeration Date | 06/16/2010
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Last Update Date | 08/24/2021
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Provider Practice Location Address
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Address Line | 1007 GREENFIELD DRIVE
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City | TIFTON
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State | GA
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Zip | 31794
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Country | US
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Telephone | 229-392-9733
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Fax |
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Provider Business Mailing Address
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Address Line | 120 US HIGHWAY 280 W STE C
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City | AMERICUS
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State | GA
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Zip | 31719-8645
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Country | US
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Telephone | 229-931-7160
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Fax | 229-931-7135
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 4160
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License Number State | GA
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