Provider Demographics
NPI:1881662484
Name:KANGAS, TRACY ANNE (MD PHD)
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:ANNE
Last Name:KANGAS
Suffix:
Gender:F
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1128 DUFF AVENUE
Mailing Address - Street 2:MCFARLAND CLINIC PC
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50010-3014
Mailing Address - Country:US
Mailing Address - Phone:515-239-4460
Mailing Address - Fax:515-239-4145
Practice Address - Street 1:1128 DUFF AVENUE
Practice Address - Street 2:MCFARLAND CLINIC PC
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-3014
Practice Address - Country:US
Practice Address - Phone:515-239-4460
Practice Address - Fax:515-956-4145
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA32532207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1179960Medicaid
IAI7762Medicare ID - Type Unspecified
IA1179960Medicaid