MEDICARE: TRACY J TACKET DO PLLC

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	5101017117	MI

Other Identifiers

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

General Provider Information

NPI Number	:	1992826366
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRACY J TACKET DO PLLC

Provider Business Mailing Address
First Line	:	3061 CHRISTY WAY
Second Line	:
City	:	SAGINAW
State	:	MI
Zip	:	48603-2267
Country	:	US
Telephone Number	:	989-791-2455
Fax Number	:

Provider Business Practice Location Address
First Line	:	24 N SAINT JOSEPH AVE
Second Line	:	SUITE G
City	:	NILES
State	:	MI
Zip	:	49120-2263
Country	:	US
Telephone Number	:	269-684-5002
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	TRACY J TACKET
Credential	:	DO
Telephone Number	:	269-684-5002

Provider Enumeration Date	:	04/03/2007
Last Update Date	:	03/15/2010

Similar Medicare Providers

1033195748 — GLENDA M GENSOLIN MD
Practice Location Address:

24 N SAINT JOSEPH AVE STE C2
NILES, MI
49120-2263

Practice Phone: 269-683-0330
Practice Fax: 269-684-0400

1952336653 — DR. FLORENTINO ARPON AQUINO M.D.
Practice Location Address:

24 N SAINT JOSEPH AVE , SUITE C-2
NILES, MI
49120-2263

Practice Phone: 269-683-0330
Practice Fax: 269-684-0400

1023145703 — DOUGLAS TACKET DO PLLC
Practice Location Address:

24 N SAINT JOSEPH AVE , SUITE G
NILES, MI
49120-2263

Practice Phone: 269-684-5002
Practice Fax:

1225256712 — MR. JOE FRANCISCO MSW, LCSW
Practice Location Address:

24 N SAINT JOSEPH AVE , SUITE G
NILES, MI
49120-2263

Practice Phone: 269-684-6870
Practice Fax: 574-252-4159

1629277439 — PAUL V DETRISAC MD PC
Practice Location Address:

24 N SAINT JOSEPH AVE
NILES, MI
49120-2263

Practice Phone: 269-684-8356
Practice Fax:

1437343373 — GLENDA M GENSOLIN MD PLLC
Practice Location Address:

24 N SAINT JOSEPH AVE STE C2
NILES, MI
49120-2263

Practice Phone: 269-683-0330
Practice Fax: 269-684-0400

Directions to “TRACY J TACKET DO PLLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.