Provider Demographics
NPI:1104892694
Name:COWLES, TRACY A (MD)
Entity type:Individual
Prefix:DR
First Name:TRACY
Middle Name:A
Last Name:COWLES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:12200 W 106TH ST
Mailing Address - Street 2:110
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66215-2300
Mailing Address - Country:US
Mailing Address - Phone:913-599-1396
Mailing Address - Fax:913-599-1399
Practice Address - Street 1:12200 W 106TH ST
Practice Address - Street 2:110
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66215-2300
Practice Address - Country:US
Practice Address - Phone:913-599-1396
Practice Address - Fax:913-599-1399
Is Sole Proprietor?:No
Enumeration Date:2006-02-24
Last Update Date:2012-09-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KS04-20549207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100160610AMedicaid
KS100160610FMedicaid
MO206852717Medicaid
KS100160610GMedicaid
MO1104892694Medicaid
KS100160610AMedicaid
MOP00740096Medicare PIN
KSE94A10000Medicare PIN
KS100160610FMedicaid
MOMA1812001Medicare Oscar/Certification
MOP00724709Medicare Oscar/Certification
MOE946768AMedicare PIN