Provider Demographics
NPI:1952307233
Name:DOERING, TRACEY ELLEN (MD)
Entity Type:Individual
Prefix:DR
First Name:TRACEY
Middle Name:ELLEN
Last Name:DOERING
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 CHURCH STREET
Mailing Address - Street 2:BAPTIST HOSPITAL
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37236
Mailing Address - Country:US
Mailing Address - Phone:615-284-2155
Mailing Address - Fax:615-284-5984
Practice Address - Street 1:2000 CHURCH ST
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37236-0001
Practice Address - Country:US
Practice Address - Phone:615-284-2155
Practice Address - Fax:615-284-5984
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-22
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD16616207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TND98382Medicare UPIN