| Doctor Name: | DR. TRACY MARIE BACIK |
| NPI Number: | 1023052081 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | D.P.M |
| License Number: | 5901002138 |
| Business Practice Address: | 408 Lake St Roscommon, MI - 486537663 |
| Business Phone Number: | 9892753668 |
| Business Fax Number: | 9892753338 |
| Mailing Address: | P.o. Box 949, 3095 West Maplehurst Road ROSCOMMON |
| State: | MI |
| Postal Code: | 486537663 |
| Phone Number: | 9892753668 |
| Fax Number: | 9892753338 |
| NPI Enumeration Date: | 06/16/2006 |
| NPI Last Update Date: | 04/23/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | 5901002138 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |