Provider Demographics
NPI:1700091709
Name:TOMLINSON, TRACY M (MD)
Entity Type:Individual
Prefix:DR
First Name:TRACY
Middle Name:M
Last Name:TOMLINSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6420 CLAYTON RD STE 2800
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63117-1811
Mailing Address - Country:US
Mailing Address - Phone:314-768-8873
Mailing Address - Fax:314-768-8776
Practice Address - Street 1:1031 BELLEVUE AVE STE 400
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63117-1858
Practice Address - Country:US
Practice Address - Phone:314-768-8873
Practice Address - Fax:314-768-8776
Is Sole Proprietor?:No
Enumeration Date:2007-05-12
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.133949207VM0101X
MA242404207VM0101X
MO2013032979207VM0101X
SCMMD.35070 TL207VM0101X
AZ46764207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
I73831Medicare UPIN