Provider Demographics
NPI:1851323265
Name:MCKAY, TRACY C (DO)
Entity Type:Individual
Prefix:DR
First Name:TRACY
Middle Name:C
Last Name:MCKAY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:38135 MARKET SQ
Mailing Address - Street 2:
Mailing Address - City:ZEPHYRHILLS
Mailing Address - State:FL
Mailing Address - Zip Code:33542-7505
Mailing Address - Country:US
Mailing Address - Phone:813-528-4975
Mailing Address - Fax:
Practice Address - Street 1:13417 US HIGHWAY 301
Practice Address - Street 2:SUITE B
Practice Address - City:DADE CITY
Practice Address - State:FL
Practice Address - Zip Code:33525-5446
Practice Address - Country:US
Practice Address - Phone:352-521-3967
Practice Address - Fax:813-355-5024
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS8256207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL263795200Medicaid
FLP00430975OtherRR MEDICARE
FL58518TMedicare PIN
FLH56519Medicare UPIN