Beverley, Tracey D
Beverley, Tracey D is an sole proprietor health care provider with primary practice located at 321 Tellico Street , Madisonville TN 37354-1194. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Beverley, Tracey D can be contacted via phone (865) 213-8594.Contact Information
Primary practice address
321 Tellico Street
Madisonville TN 37354-1194
Phone: (865) 213-8594
Fax: (865) 213-8359
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | MD37666 | Tennessee |
Profile Details
| NPI number | 1083651533 |
|---|---|
| LBN Legal business name | Beverley, Tracey D |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 1st, 2006 |
| Last updated | Dec 2nd, 2013 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1083651533 | NPPES |
| Tennessee | MEDICAID | Q000340 | |
| Tennessee | Other | 4330111 |
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