Provider Demographics
NPI:1790898138
Name:LATHROP, TRACY H (MD)
Entity Type:Individual
Prefix:DR
First Name:TRACY
Middle Name:H
Last Name:LATHROP
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:2000 PERIMETER PARK DR STE 200
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-8442
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8300 HEALTH PARK STE 320
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-4731
Practice Address - Country:US
Practice Address - Phone:919-781-9650
Practice Address - Fax:919-781-3572
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC9800946207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1790898138Medicaid