Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | T-2562 | MS |
NPI | 1003170325 |
---|---|
Provider Name | Tracye Jean-Marie Lawyer |
First Address | Jackson, MS 39216-4505 |
Second Address | Jackson, MS 39216-4505 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2012 |
Last Update Date | 02/07/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
RES000 | (02) | MS |