Martin, Tracy B
Martin, Tracy B is an individual health care provider with primary practice located at 2610 Trinity Dr Ste 14 , Los Alamos NM 87544-2362. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Adult Medicine, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Martin, Tracy B can be contacted via phone (505) 500-8213.Contact Information
Primary practice address
2610 Trinity Dr Ste 14
Los Alamos NM 87544-2362
Phone: (505) 500-8213
Fax: (505) 451-0580
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Adult Medicine | 207QA0505X | 99PA28 | New Mexico |
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 99-PA28 | New Mexico |
Profile Details
| NPI number | 1952460057 |
|---|---|
| LBN Legal business name | Martin, Tracy B |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 6th, 2006 |
| Last updated | Oct 11th, 2022 - about 2 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 | 1952460057 | NPPES |
| New Mexico | MEDICAID | 000N1651 | |
| New Mexico | Other | 10029201 | |
| New Mexico | Other | QMP000003399104 |
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