| Jack Tracy Ii, Ph.d. Pyschological Services, Pllc | |
|
1006 24th Ave Nw Ste 100 Norman OK 73069-6344 | |
| (405) 801-2836 | |
| Not Available |
| Full Name | Jack Tracy Ii, Ph.d. Pyschological Services, Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 1006 24th Ave Nw Ste 100, Norman, Oklahoma |
| Authorized Official Name and Position | Jack Frank Tracy (LICENSED PSYCHOLOGIST) |
| Authorized Official Contact | 4052136130 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jack Tracy Ii, Ph.d. Pyschological Services, Pllc 1006 24th Ave Nw Ste 100 Norman OK 73069-6344 Ph: (405) 801-2836 | Jack Tracy Ii, Ph.d. Pyschological Services, Pllc 1006 24th Ave Nw Ste 100 Norman OK 73069-6344 Ph: (405) 801-2836 |
| NPI Number | 1457657165 |
|---|---|
| Provider Enumeration Date | 01/28/2011 |
| Last Update Date | 02/09/2012 |
| Medicare PECOS PAC ID | 8022284579 |
|---|---|
| Medicare Enrollment ID | O20120104000556 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457657165 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 1120 (Oklahoma) | Primary |
| Provider Name | Jack F Tracy |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1609089655 PECOS PAC ID: 0244407435 Enrollment ID: I20120111000118 |
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