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General NPI Number Information
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NPI Number | 1639307101
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Entity Type | Organization
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Legal Business Name | DR. TRACY A. MERRELL, D.P.M., P.C.
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Dates
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Enumeration Date | 06/23/2009
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Last Update Date | 06/23/2009
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Provider Practice Location Address
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Address Line | 1747 MEDICAL CENTER PKWY SUITE 100
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City | MURFREESBORO
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State | TN
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Zip | 37129-2563
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Country | US
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Telephone | 615-848-1902
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Fax |
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Provider Business Mailing Address
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Address Line | 1747 MEDICAL CENTER PKWY SUITE 100
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City | MURFREESBORO
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State | TN
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Zip | 37129-2563
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Country | US
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Telephone | 615-848-1902
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. TRACY ALAN MERRELL
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Credential | D.P.M.
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Telephone | 615-848-1902
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 484
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License Number State | TN
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