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NPI Code Detail

MEDICARE: TRACEY K PEATROSS M.D.

MEDICARE: TRACEY K PEATROSS 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
1207V00000XObstetrics & Gynecology Physician38225AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1730166349
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRACEY K PEATROSS M.D.
Provider Business Mailing Address
First Line : 1530 E WILLIAMS FIELD RD STE 201
Second Line :
City : GILBERT
State : AZ
Zip : 85295-1825
Country : US
Telephone Number : 480-914-0013
Fax Number :
Provider Business Practice Location Address
First Line : 2400 S AVENUE A
Second Line :
City : YUMA
State : AZ
Zip : 85364-7170
Country : US
Telephone Number : 928-344-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/23/2005
Last Update Date : 02/05/2024

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