Provider Demographics
NPI:1366650939
Name:HOELZLE, TRACEY E (MD)
Entity Type:Individual
Prefix:DR
First Name:TRACEY
Middle Name:E
Last Name:HOELZLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 378
Mailing Address - Street 2:
Mailing Address - City:SANDUSKY
Mailing Address - State:OH
Mailing Address - Zip Code:44871-0378
Mailing Address - Country:US
Mailing Address - Phone:419-609-1112
Mailing Address - Fax:419-609-1123
Practice Address - Street 1:112 INDEPENDENCE WAY
Practice Address - Street 2:SUITE 160
Practice Address - City:CLYDE
Practice Address - State:OH
Practice Address - Zip Code:43410-9811
Practice Address - Country:US
Practice Address - Phone:419-502-3534
Practice Address - Fax:567-855-5231
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2016-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35880972084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry