Short, Tracee Chavawn
Short, Tracee Chavawn is an individual health care provider with primary practice located at 3401 North Blvd Ste 200-B, Baton Rouge LA 70806-3743. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / General Practice, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / General Practice is her primary health care specialty. Short, Tracee Chavawn can be contacted via phone (225) 381-2615.Contact Information
Primary practice address
3401 North Blvd Ste 200-B
Baton Rouge LA 70806-3743
Phone: (225) 381-2615
Fax: (225) 381-2638
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / General Practice | 208D00000X | E-6871 | Arkansas |
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X |
Profile Details
| NPI number | 1780813311 |
|---|---|
| LBN Legal business name | Short, Tracee Chavawn |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 2nd, 2009 |
| Last updated | Sep 23rd, 2014 - about 11 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 | 1780813311 | NPPES |
| Louisiana | Other | 324582YUB6 | MEDICARE PTAN |
| Louisiana | MEDICAID | 2347799 | MEDICARE PTAN |
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