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Contact Information

TRACY S MAYBERRY, DPM
1683 WASHINGTON RD
EAST POINT, GA30344-4265
 Phone: 404-766-6400
 Fax: 404-766-6450
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
 

Primary Podiatric Medicine

213EP1101X 48 Podiatry
 

Radiology

213ER0200X 48 Podiatry
 

Sports Medicine

213ES0000X 48 Podiatry
 

Surgery, Foot

213ES0131X 48 Podiatry
 

Surgery, Foot & Ankle

213ES0103X 48 Podiatry
Indicates primary specialty

NPI Profile & details for TRACY S MAYBERRY · (Female)

NPI Number 1497738413
Status Active
Credentials DPM (Doctor of Podiatric Medicine)
Entity Individual
Enumeration date 11/23/2005
Last updated 02/08/2021 - About 5 years ago
Sole proprietor 1 Yes
Identifiers
  • GA License # 000763
  • GA License # POD000763
  • GA Medicaid 000672119F
  • GA Other 480028687 RAILROAD MEDICARE
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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