Provider Demographics
NPI:1285698886
Name:WOLF, TRACY M (MD)
Entity type:Individual
Prefix:DR
First Name:TRACY
Middle Name:M
Last Name:WOLF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:TRACY
Other - Middle Name:M
Other - Last Name:PLOCK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:500 W 144TH AVE STE 230
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80023-9328
Mailing Address - Country:US
Mailing Address - Phone:303-665-2603
Mailing Address - Fax:303-665-2605
Practice Address - Street 1:500 W 144TH AVE STE 230
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80023-9328
Practice Address - Country:US
Practice Address - Phone:303-665-2603
Practice Address - Fax:303-665-2605
Is Sole Proprietor?:No
Enumeration Date:2006-04-12
Last Update Date:2017-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO34643207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1346436Medicaid
CO400000680OtherRAILROAD MEDICARE
COG5658Medicare PIN
CO400000680OtherRAILROAD MEDICARE