Provider Demographics
NPI:1225221864
Name:HOEG, TRACY B (MD)
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:B
Last Name:HOEG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:TRACY
Other - Middle Name:B
Other - Last Name:O'MARA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3010 BEARD RD
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-3442
Mailing Address - Country:US
Mailing Address - Phone:707-255-8825
Mailing Address - Fax:707-255-9325
Practice Address - Street 1:3421 VILLA LN STE 2B
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558-3060
Practice Address - Country:US
Practice Address - Phone:707-255-5454
Practice Address - Fax:707-255-5411
Is Sole Proprietor?:No
Enumeration Date:2007-08-27
Last Update Date:2018-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI50822-020208D00000X
CAC140275208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice