Tracy J Tacket Do Pllc

LBN: Tracy J Tacket Do Pllc
Tracy J Tacket Do Pllc is an health care organization with primary practice located at 24 N Saint Joseph Ave Suite G, Niles MI 49120-2263. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Tracy J Tacket Do Pllc can be contacted via phone (269) 684-5002, or through Tacket, Tracy J via phone (269) 684-5002.

Contact Information

Primary practice address
24 N Saint Joseph Ave Suite G Niles MI 49120-2263
Phone: (269) 684-5002
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Tacket, Tracy J Doctor of Osteopathy (DO)
Phone: (269) 684-5002

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 5101017117 Michigan

Profile Details

NPI number 1992826366
LBN Legal business name Tracy J Tacket Do Pllc
DBA Doing business as
Authorized official Tacket, Tracy J Doctor of Osteopathy (DO)
Entity Organization
Organization subpart 1 No
Enumeration date Apr 3rd, 2007
Last updated Mar 15th, 2010 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1992826366 NPPES
Michigan MEDICAID 4994944

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