Provider Demographics
NPI:1235232414
Name:AIGNER, TRACY LEE (OD)
Entity Type:Individual
Prefix:MRS
First Name:TRACY
Middle Name:LEE
Last Name:AIGNER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:TRACY
Other - Middle Name:LEE
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:PO BOX 1800
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20604-2810
Mailing Address - Country:US
Mailing Address - Phone:301-843-1000
Mailing Address - Fax:301-843-1919
Practice Address - Street 1:2955 CRAIN HWY
Practice Address - Street 2:SUITES A & B
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20601-2810
Practice Address - Country:US
Practice Address - Phone:301-843-1000
Practice Address - Fax:301-843-1919
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2010-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDTA2009152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist