Provider Demographics
NPI:1982867057
Name:KLIMAZ, TRACY LYNN (DPM)
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:LYNN
Last Name:KLIMAZ
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5253 PROVIDENCE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23464-4201
Mailing Address - Country:US
Mailing Address - Phone:757-495-6113
Mailing Address - Fax:757-495-6156
Practice Address - Street 1:5253 PROVIDENCE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23464-4201
Practice Address - Country:US
Practice Address - Phone:757-495-6113
Practice Address - Fax:757-495-6156
Is Sole Proprietor?:No
Enumeration Date:2008-07-08
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0103301029213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery