National Provider Identifier Database

TRACY FAMILY PRACTICE CLINIC PA
Preferred Provider Organization

A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level.


Contact Information

TRACY FAMILY PRACTICE CLINIC PA
1940 S WHITEHEAD DR
DEWITT, AR72042-2906
Phone: 870-946-4505
Fax: 870-946-2428
Website:
Specialty Taxonomy Code
* Preferred Provider Organization 305R00000X

* Indicates primary specialty

NPI Profile & details for TRACY FAMILY PRACTICE CLINIC PA

NPI Number 1659319150
Legal business name
LBN
TRACY FAMILY PRACTICE CLINIC PA
Authorized official WALLACE TRACY - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 06/04/2006
Last updated 09/16/2010 - About 16 years ago
Sole proprietor1 Not specified
Identifiers
  • AR License #: C7340

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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