Roberts, Tracy Lynn
Roberts, Tracy Lynn is an individual health care provider with primary practice located at 3850 S National Ave Suite 300, Springfield MO 65807-5287. She recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as her primary health care specialty. Roberts, Tracy Lynn can be contacted via phone (417) 269-6170.Contact Information
Primary practice address
3850 S National Ave Suite 300
Springfield MO 65807-5287
Phone: (417) 269-6170
Fax: (417) 269-6992
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | R2P74 | Missouri |
Profile Details
| NPI number | 1063472207 |
|---|---|
| LBN Legal business name | Roberts, Tracy Lynn |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 23rd, 2006 |
| Last updated | Mar 23rd, 2023 - 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 | 1063472207 | NPPES |
| Missouri | Other | 300100943 | RRR MEDICARE |
| Missouri | Other | 1256 | RRR MEDICARE |
| Missouri | MEDICAID | 209728914 | RRR MEDICARE |
| Missouri | MEDICAID | 138386001 | RRR MEDICARE |
| Missouri | Other | P00807645 | RRR MEDICARE |
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