Tracy Elmer Strevey Jr., M.D.

Individual provider Active NPI Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician · Frontenac, MO

NPI 1508024753 · NPPES record last updated May 23, 2008

Key facts

NPI
1508024753
Entity type
Individual (NPI type 1)
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X
License
2007001270 (MO)
Practice address
1509 Woodgate Dr
Frontenac, MO 63131-4724
Phone
(314) 966-1044
Fax
(314) 966-7720
NPI assigned
May 23, 2008
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2007001270MOMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 2007001270 MO Yes

Addresses

Primary practice location

1509 Woodgate Dr
Frontenac, MO 63131-4724

Mailing address

1509 Woodgate Dr
Frontenac, MO 63131-4724
Phone (314) 966-1044

Other providers in Frontenac, MO

All providers in Frontenac, MO · Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Missouri

Sources for this page

Verify at the official NPI Registry.