Provider Demographics
NPI:1770654196
Name:BARR, TRACY WATSON (MD)
Entity type:Individual
Prefix:DR
First Name:TRACY
Middle Name:WATSON
Last Name:BARR
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 1:2172 WHITEKIRK ST NW
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30152-8277
Mailing Address - Country:US
Mailing Address - Phone:404-374-3700
Mailing Address - Fax:
Practice Address - Street 1:1150 LAKE HEARN DR STE 500
Practice Address - Street 2:
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30342-1570
Practice Address - Country:US
Practice Address - Phone:470-993-6287
Practice Address - Fax:470-961-7300
Is Sole Proprietor?:No
Enumeration Date:2006-11-10
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA58030208000000X
GA058030208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics