| Tracey A Haas, DO | |
|
2710 Harney St Ste 202, Laramie, WY 82072-2899 | |
| (307) 766-3313 | |
| Not Available |
| Full Name | Tracey A Haas |
|---|---|
| Gender | Female |
| Speciality | Family Medicine |
| Location | 2710 Harney St Ste 202, Laramie, Wyoming |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346264561 | NPI | - | NPPES |
| 181979903 | Medicaid | TX | |
| 0056096 | Other | CO | MEDICAL LICENSE |
| 181979904 | Medicaid | TX | |
| M0100 | Other | TX | TX STATE LICENSE |
| 12820A | Other | WY | MEDICAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | DR.0056096 (Colorado) | Secondary |
| 207Q00000X | Family Medicine | M0100 (Texas) | Secondary |
| 207Q00000X | Family Medicine | 12820A (Wyoming) | Primary |
| Entity Name | Peak Vista Community Health Centers |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1730166034 PECOS PAC ID: 4688583974 Enrollment ID: O20031110000337 |
| Mailing Address | Practice Location Address |
|---|---|
| Tracey A Haas, DO 2710 Harney St Ste 202, Laramie, WY 82072-2899 Ph: (307) 766-3313 | Tracey A Haas, DO 2710 Harney St Ste 202, Laramie, WY 82072-2899 Ph: (307) 766-3313 |
Patrick W. Tufts, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 255 N 30th St, Laramie, WY 82072 Phone: 307-755-4406 | |
Kurt Samuel Johnson, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1000 E University Ave, Laramie, WY 82071 Phone: 307-766-5071 Fax: 307-761-9319 | |
Dr. Darren Lamar Mikesell, D.O Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 2710 Harney St Ste 100, Laramie, WY 82072 Phone: 307-742-3242 Fax: 307-742-3242 | |
Dr. Daniel George Radosevich, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1000 E University Ave, Department 3068, Laramie, WY 82071 Phone: 307-766-2130 Fax: 307-766-2711 | |
Robert M Martino, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1771 Eaglecrest Ct, Laramie, WY 82072 Phone: 701-306-7497 | |
Michael Peter Meyer, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1000 E University Ave # 3068, Laramie, WY 82071 Phone: 307-766-2130 |