OrganizationActive
Tracy Family Practice Clinic PA
NPI 1659319150 · Preferred Provider Organization · De Witt, AR
Provider details
- NPI number
- 1659319150
- Entity type
- Organization
- Primary specialty
- Preferred Provider OrganizationManaged Care Organizations
- Organization subpart
- No
- Authorized official
- Wallace Tracy, Owner(870) 946-4505
- License
- C7340 (AR)
Specialties & taxonomies
Managed Care Organizations
Practice location
1940 S Whitehead Dr
De Witt, AR 72042-2906
Phone: (870) 946-4505
Fax: (870) 946-2428
Approximate (ZIP-level) locationGet directions
Mailing address
1940 S Whitehead Dr
De Witt, AR 72042-2906
Registry dates
- Enumerated
- 2006-06-04
- Last updated
- 2010-09-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.