Provider Demographics
NPI:1447550512
Name:SUMMER, TRACI R (PHARMD)
Entity type:Individual
Prefix:MS
First Name:TRACI
Middle Name:R
Last Name:SUMMER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:286 E 7TH ST
Mailing Address - Street 2:
Mailing Address - City:DOUGLAS
Mailing Address - State:AZ
Mailing Address - Zip Code:85607-2868
Mailing Address - Country:US
Mailing Address - Phone:520-364-1358
Mailing Address - Fax:
Practice Address - Street 1:9460 E GOLF LINKS RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85730-1337
Practice Address - Country:US
Practice Address - Phone:520-296-4532
Practice Address - Fax:520-296-4725
Is Sole Proprietor?:No
Enumeration Date:2010-10-23
Last Update Date:2024-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS014310183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist