MEDICARE: DR. TRACEY ALBERTHA LOCKHART WRIGHT MD

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
1	207Q00000X	Family Medicine Physician	4301509873	MI
2	207Q00000X	Family Medicine Physician	E-15558	AR

General Provider Information

NPI Number	:	1104446103
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TRACEY ALBERTHA LOCKHART WRIGHT MD

Provider Business Mailing Address
First Line	:	33333 W 12 MILE RD
Second Line	:
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48334-3312
Country	:	US
Telephone Number	:	248-536-2127
Fax Number	:	248-893-6852

Provider Business Practice Location Address
First Line	:	33333 W 12 MILE RD
Second Line	:
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48334-3312
Country	:	US
Telephone Number	:	248-536-2127
Fax Number	:	248-893-6952

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/20/2020
Last Update Date	:	07/02/2025

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