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NPI Code Detail

MEDICARE: DR. TRACEY GOODMAN SKALE M.D.

MEDICARE: DR. TRACEY GOODMAN SKALE M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician35-06-2674OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000316132OTHERANRHEM PROVIDER
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1003830647
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TRACEY GOODMAN SKALE M.D.
Provider Business Mailing Address
First Line : 4965 TAFT PL
Second Line :
City : CINCINNATI
State : OH
Zip : 45243-3961
Country : US
Telephone Number : 513-658-0012
Fax Number :
Provider Business Practice Location Address
First Line : 2621 VICTORY PKWY
Second Line :
City : CINCINNATI
State : OH
Zip : 45206-1754
Country : US
Telephone Number : 513-861-6688
Fax Number : 513-559-3848
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/27/2006
Last Update Date : 03/07/2023

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Directions to “ DR. TRACEY GOODMAN SKALE M.D.” Practice Location

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