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General NPI Number Information
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NPI Number | 1376767079
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Entity Type | Individual
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Provider Name | TRACY JOSEPH ANDERSON M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 10/24/2010
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Provider Practice Location Address
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Address Line | 200 HAWKINS DR
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City | IOWA CITY
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State | IA
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Zip | 52242-1007
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Country | US
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Telephone | 208-450-2011
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Fax |
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Provider Business Mailing Address
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Address Line | WEINGARTL 15
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City | NATTERS
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State | TIROL
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Zip | 6161
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Country | AT
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Telephone | 208-450-2011
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Fax |
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | M-8414
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 32547
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | ME-89192
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 42192
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License Number State | CO
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Taxonomy #5
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 37627
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License Number State | IA
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