Provider Demographics
NPI:1548820848
Name:DUGGER, TRACEY A
Entity type:Individual
Prefix:
First Name:TRACEY
Middle Name:A
Last Name:DUGGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14605 CLINTON RD
Mailing Address - Street 2:
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72118-1404
Mailing Address - Country:US
Mailing Address - Phone:501-960-1038
Mailing Address - Fax:
Practice Address - Street 1:14605 CLINTON RD
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72118-1404
Practice Address - Country:US
Practice Address - Phone:501-960-1038
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-18
Last Update Date:2019-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347E00000XTransportation ServicesTransportation Broker