Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. TRACY D. MICKELSEN, CSFA
Active Sole ProprietorMR. TRACY D. MICKELSEN, CSFA is a Surgical Physician Assistant healthcare provider located in MERIDIAN, Idaho. NPI 1801073655 is currently active in the NPPES registry. Verify at CMS.
Surgical Physician Assistant · MERIDIAN, ID
Registration Details
- NPI Number
- 1801073655
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jan 23, 2008 (18.412107735582 yrs)
- Last Updated
- Dec 7, 2017
- License
-
178692 (ID)
- Sole Proprietor
- Yes
Practice Information
- Address
-
3015 E MAGIC VIEW DRMERIDIAN, ID, 836423743Browse ID providers · Browse ZIP 83642
- Phone
- 2088552410
- Fax
- 2084825515
- Primary Specialty
-
Surgical Physician Assistant
363AS0400X
Other Surgical Physician Assistant Providers in MERIDIAN, ID
| Name | Credential | NPI |
|---|---|---|
| CLAIRE MAGNOLO | PA-C | 1003869355 |
| MR. WILLIAM B CURTIS | O.P.A.-C | 1093853871 |
| MRS. SHANNON L GARDINER | PA | 1689701260 |
| TRACEY REEVE | PA-C | 1174789994 |
| DON H CURTIS | CSFA | 1982937066 |
| JACOB RADIL | PA-C | 1811337017 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.