Provider Demographics
NPI:1346442951
Name:MCDONALD, TRACY ANN (RPH)
Entity Type:Individual
Prefix:MR
First Name:TRACY
Middle Name:ANN
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1835 COLUMBINE DR
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59105-4223
Mailing Address - Country:US
Mailing Address - Phone:406-259-3792
Mailing Address - Fax:
Practice Address - Street 1:2601 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-6652
Practice Address - Country:US
Practice Address - Phone:406-652-2263
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT3381183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist