DR. TRACY THUY PHAN (NPI# 1619592987) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619592987 |
| Entity Type | Individual |
| Full Name | DR. TRACY THUY PHAN |
| Credential | DO |
| Practice Address |
1120 15th St Augusta GA 30912-0004 |
| Mailing Address |
192 Windsong Ln Sw Lilburn GA 30047-3949 |
| Practice Telephone | 7067213157 |
| Mailing Telephone | 4042743233 |
| Enumeration Date | 2020-06-12 |
| Last Update Date | 2020-06-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 11987 | GA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972137446 | Tracy Phan | Nurse Practitioner | 969 Story Rd Unit 6060a, San Jose, CA 95122-4601 | 2020-02-24 |
| 1558761676 | Tracy Phan | Pharmacist | 17835 Gale Ave, City of Industry, CA 91748-1526 | 2014-08-26 |
| 1780968487 | Tracy Elizabeth Phan | Pharmacist | 2500 Alhambra Ave, Martinez, CA 94553-3156 | 2011-09-30 |
| 1659688638 | Tracy Huyen Tram Phan | Pharmacist | 4300 Elverta Rd, Antelope, CA 95843-6700 | 2010-09-11 |
| Street Address |
1120 15TH ST |
| City | AUGUSTA |
| State | GA |
| Zip Code | 30912-0004 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427051556 | Gyanendra Kumar Sharma | Internal Medicine | 1120 15th St, Augusta, GA 30912-0004 | 2005-05-23 |
| 1912508532 | Lacey Nichol Preston | Physician Assistant | 1120 15th St, Augusta, GA 30912-0004 | 2020-11-02 |
| 1992302988 | Victoria Mae Pregibon | Physician Assistant | 1120 15th St, Augusta, GA 30912-0004 | 2020-10-03 |
| 1275130239 | Tanya Renee Hall | Nurse Practitioner | 1120 15th St, Augusta, GA 30912-0004 | 2020-10-02 |
| 1144847864 | Cassandra Marie Voong | Internal Medicine | 1120 15th St, Augusta, GA 30912-0004 | 2020-06-29 |
| 1245857002 | Morgan Rowe | Nurse Practitioner | 1120 15th St, Augusta, GA 30912-0004 | 2020-06-28 |
| 1639795990 | Lauren Christine Bush | Audiologist | 1120 15th St, Augusta, GA 30912-0004 | 2020-06-23 |
| 1811513575 | Ashley Danielle Fox | Internal Medicine | 1120 15th St, Augusta, GA 30912-0006 | 2020-06-18 |
| 1265058994 | Matthew Craddock | Psychiatry & Neurology | 1120 15th St, Augusta, GA 30912-0004 | 2020-06-18 |
| 1437775301 | Joseph John Arellano | Emergency Medicine | 1120 15th St, Augusta, GA 30912-0004 | 2020-06-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548885940 | Hannah Gullickson Folsom | Family Medicine | 1459 Laney Walker Blvd Ae 3042, Augusta, GA 30912 | 2020-06-11 |
| 1487278909 | Robert Kennedy | Internal Medicine | Augusta University Internal Medicine Residency Program, 1120 15th Street, Bi 5070, Augusta, GA 30912 | 2020-06-01 |
| 1952968737 | Kayla M. Lasota | Pediatrics | 11230 115th St Ae3042, Augusta, GA 30912 | 2019-05-28 |
| 1003379280 | Kayla Cox | Internal Medicine | 1120 15th St Bi5070, Augusta, GA 30912 | 2019-04-13 |
| 1619435740 | Justin Ray Mackert | Student in an Organized Health Care Education/Training Program | Augusta University, 1120 15th Street, Gc 5110, Augusta, GA 30912 | 2019-03-07 |
| 1417444167 | Victor Celis | Dentist | John Wesley Gilbert Dr, Augusta, GA 30912 | 2018-04-18 |
| 1487157921 | Julie Ann Matsen | Student in an Organized Health Care Education/Training Program | 997 St. Sebastian Way, Eg-2021-10, Augusta Univ., Dept. of Psychiatry & Health Behavior, Augusta, GA 30912 | 2018-03-12 |
| 1497287031 | Luke Yuung-jier Chang | Ophthalmology | 1120 15th St # Ba2720, Augusta, GA 30912 | 2017-04-02 |
| 1821537622 | Lashawn Kay Boone | Nurse Practitioner | 1445 Harper St, Augusta, GA 30912 | 2017-02-14 |
| 1134675564 | Arnab Saha | Internal Medicine | 1120 15 Th St., Augusta, GA 30912 | 2016-08-26 |
| Find all providers in zip 30912 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649889874 | Kateri Jeffery | Family Medicine | 12 Shuman Ave Ste 3, Augusta, ME 04330-6020 | 2020-07-23 |
| 1548885783 | Candace Clinton | Family Medicine | 1120 15th St # Hb4000, Augusta, GA 30912-0004 | 2020-06-13 |
| 1750906012 | Nand Vinod Patel | Family Medicine | 3039 Washington Rd, Augusta, GA 30907-3829 | 2020-06-12 |
| 1114542396 | Lauren C Robinson | Family Medicine | 1120 15th St # Hb3000e, Augusta, GA 30912-0004 | 2020-06-12 |
| 1831714211 | Soren Knudsen Estvold | Family Medicine | 1120 15th St # Hb-4000, Augusta, GA 30912-0004 | 2020-06-11 |
| 1548885940 | Hannah Gullickson Folsom | Family Medicine | 1459 Laney Walker Blvd Ae 3042, Augusta, GA 30912 | 2020-06-11 |
| 1942793005 | Rebecca Tate Jones | Family Medicine | 1120 15th St Augusta Ga 30912, Augusta, GA 30912-0001 | 2018-06-12 |
| 1811480411 | Sonya Janice Chelliah | Family Medicine | 1120 15th St # Hb3020, Augusta, GA 30912-0004 | 2018-06-08 |
| 1447741269 | Akua E Asiamah | Family Medicine | 1120 15th St Augusta University, Augusta, GA 30912-0001 | 2018-05-29 |
| 1457766800 | Susan B. Allen Memorial Hospital | Family Medicine | 401 W 7th Ave, Augusta, KS 67010-1309 | 2014-06-24 |
| Find all providers in AUGUSTA | ||||
Please comment or provide details below to improve the information on DR. TRACY THUY PHAN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.