Provider Demographics
NPI:1427083872
Name:GEMMELL, TRACY JO (MD)
Entity type:Individual
Prefix:DR
First Name:TRACY
Middle Name:JO
Last Name:GEMMELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:911 LIGONIER STREET
Mailing Address - Street 2:STE 205
Mailing Address - City:LATROBE
Mailing Address - State:PA
Mailing Address - Zip Code:15650
Mailing Address - Country:US
Mailing Address - Phone:724-532-2322
Mailing Address - Fax:724-532-2405
Practice Address - Street 1:841 HOSPITAL RD STE 2500
Practice Address - Street 2:
Practice Address - City:INDIANA
Practice Address - State:PA
Practice Address - Zip Code:15701-3699
Practice Address - Country:US
Practice Address - Phone:724-427-2797
Practice Address - Fax:724-427-2715
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD060368L207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001693660001Medicaid
005930UEKMedicare ID - Type Unspecified
PA001693660001Medicaid