| Doctor Name: | TRACY FOSSAS BURKE |
| NPI Number: | 1063785962 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 006353 |
| Business Practice Address: | 5471 Chamblee Dunwoody Rd Dunwoody, GA - 303384114 |
| Business Phone Number: | 7704810889 |
| Business Fax Number: | |
| Mailing Address: | 5471 Chamblee Dunwoody Rd, DUNWOODY |
| State: | GA |
| Postal Code: | 303384114 |
| Phone Number: | 7704810889 |
| Fax Number: | |
| NPI Enumeration Date: | 02/23/2012 |
| NPI Last Update Date: | 02/23/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 006353 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |