Provider Demographics
NPI:1073540902
Name:AUSTIN & TREACY, P.A.
Entity Type:Organization
Organization Name:AUSTIN & TREACY, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:CARIN
Authorized Official - Middle Name:B
Authorized Official - Last Name:ENGLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-722-6655
Mailing Address - Street 1:324 W SUPERIOR ST
Mailing Address - Street 2:800 MEDICAL ARTS
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55802-1701
Mailing Address - Country:US
Mailing Address - Phone:218-722-6655
Mailing Address - Fax:218-722-8582
Practice Address - Street 1:324 W SUPERIOR ST
Practice Address - Street 2:800 MEDICAL ARTS
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55802-1701
Practice Address - Country:US
Practice Address - Phone:218-722-6655
Practice Address - Fax:218-722-8582
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN813261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MND75802Medicare UPIN
MND75506Medicare UPIN