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General NPI Number Information
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NPI Number | 1649438524
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Entity Type | Individual
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Provider Name | TRACY JO LORDS DO
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Gender | Female
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Dates
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Enumeration Date | 05/28/2008
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Last Update Date | 04/08/2024
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Provider Practice Location Address
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Address Line | 401 15TH AVE S SUITE 109
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City | GREAT FALLS
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State | MT
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Zip | 59405-4334
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Country | US
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Telephone | 406-727-6311
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Fax |
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Provider Business Mailing Address
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Address Line | 401 15TH AVE S STE. 109
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City | GREAT FALLS
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State | MT
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Zip | 59405-4334
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Country | US
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Telephone | 406-727-6311
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Fax | 406-727-1070
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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 | 11013350A
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License Number State | IN
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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 | 2828
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License Number State | WI
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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 | 12371
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License Number State | MT
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