person
Mr. Tracy D. Mickelsen, CSFA
Surgical Physician Assistant in Meridian, Idaho
NPI 1801073655

Tracy D. Mickelsen is a Surgical Physician Assistant based in Meridian, ID and is specialized in Surgical. Tracy D. Mickelsen practices in Meridian, ID and has the professional credentials of CSFA. The NPI Number for Tracy D. Mickelsen is 1801073655 and holds a License No. 178692 (Idaho).

The current practice location address for Tracy D. Mickelsen is 3015 E Magic View Dr, Meridian, ID and can be reached out via phone at 208-855-2410 and via fax at 208-482-5515.

Location: 3015 E Magic View Dr, Meridian, ID, 83642-3743
person
Provider Profile Details
NPI Number
1801073655
Provider Name
Tracy D. Mickelsen
Credential
CSFA
Provider Entity Type
Individual
Gender
Male
Address
3015 E Magic View Dr, Meridian, ID, 83642-3743
Phone Number
208-855-2410
Fax Number
208-482-5515
Provider Enumeration Date
01/23/2008
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
3015 E Magic View Dr
City
State
Zip
83642-3743
Phone Number
208-855-2410
Fax Number
208-482-5515
person
Provider Business Mailing Address Details
Address
3015 E Magic View Dr
City
State
Zip
83642-3743
Phone Number
208-855-2410
Fax Number
208-482-5515
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Surgical
Taxonomy
License No.
178692 (Idaho)
Definition
Definition to come...
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