Provider Demographics
NPI:1043423973
Name:MORGAN, TRACY COLLEEN
Entity Type:Individual
Prefix:MRS
First Name:TRACY
Middle Name:COLLEEN
Last Name:MORGAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1805 CATHEDRAL HILL DR
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:OH
Mailing Address - Zip Code:45103-8911
Mailing Address - Country:US
Mailing Address - Phone:513-797-1036
Mailing Address - Fax:
Practice Address - Street 1:1805 CATHEDRAL HILL DR
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:OH
Practice Address - Zip Code:45103-8911
Practice Address - Country:US
Practice Address - Phone:513-797-1036
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor