Provider Demographics
NPI:1972677938
Name:RAUSCH, TRACY (MD)
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:
Last Name:RAUSCH
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 1:4915 CUSTER AVE
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59106-2381
Mailing Address - Country:US
Mailing Address - Phone:406-839-8809
Mailing Address - Fax:406-969-1174
Practice Address - Street 1:4915 CUSTER AVE
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59106-2381
Practice Address - Country:US
Practice Address - Phone:406-839-8809
Practice Address - Fax:406-969-1174
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2015-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK9639207R00000X
MT10371207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H42066OtherUPIN