Provider Demographics
NPI:1649231804
Name:RINGO, TRACY LYNETTE (DO)
Entity Type:Individual
Prefix:DR
First Name:TRACY
Middle Name:LYNETTE
Last Name:RINGO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9565 MIDWEST AVE STE C
Mailing Address - Street 2:
Mailing Address - City:GARFIELD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44125-2421
Mailing Address - Country:US
Mailing Address - Phone:216-508-6500
Mailing Address - Fax:216-508-6501
Practice Address - Street 1:9565 MIDWEST AVE STE C
Practice Address - Street 2:
Practice Address - City:GARFIELD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44125-2421
Practice Address - Country:US
Practice Address - Phone:216-508-6500
Practice Address - Fax:216-508-6501
Is Sole Proprietor?:No
Enumeration Date:2006-03-29
Last Update Date:2017-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-007796207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2415158Medicaid
OH2415158Medicaid