Provider Demographics
NPI:1942980412
Name:TRACY EYECARE CENTER PLLC
Entity Type:Organization
Organization Name:TRACY EYECARE CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:TRACY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:270-293-6555
Mailing Address - Street 1:2651 PERKINS CREEK DR APT 1025
Mailing Address - Street 2:
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42001-7535
Mailing Address - Country:US
Mailing Address - Phone:270-293-6555
Mailing Address - Fax:
Practice Address - Street 1:1713 HIGHWAY 121 BYP N
Practice Address - Street 2:SUITE B
Practice Address - City:MURRAY
Practice Address - State:KY
Practice Address - Zip Code:42071
Practice Address - Country:US
Practice Address - Phone:270-216-2020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-20
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty