Warren, John Tracy

Warren, John Tracy is an sole proprietor health care provider with primary practice located at 11 Pond View Dr , Jericho VT 05465-2030. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Geriatric Medicine. Allopathic & Osteopathic Physicians / Geriatric Medicine is his primary health care specialty. Warren, John Tracy can be contacted via phone (920) 435-1503.

Contact Information

Primary practice address
11 Pond View Dr Jericho VT 05465-2030
Phone: (920) 435-1503
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 29771 Wisconsin
Allopathic & Osteopathic Physicians / Geriatric Medicine 207QG0300X 29771-020 Wisconsin

Profile Details

NPI number 1407871684
LBN Legal business name Warren, John Tracy
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 12th, 2006
Last updated Nov 23rd, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407871684 NPPES
Wisconsin MEDICAID 31516000

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