| Doctor Name: | TRACY D BLAND DUBOSE |
| NPI Number: | 1952395535 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MD |
| License Number: | 052865 |
| Business Practice Address: | 5440 Hillandale Drive Department Of Ob Gyn Lithonia, GA - 30058 |
| Business Phone Number: | 7703222716 |
| Business Fax Number: | 7703223244 |
| Mailing Address: | 3495 Piedmont Road Ne, Nine Piedmont Center ATLANTA |
| State: | GA |
| Postal Code: | 30305 |
| Phone Number: | 4043647000 |
| Fax Number: | 4043644732 |
| NPI Enumeration Date: | 09/09/2005 |
| NPI Last Update Date: | 02/12/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207V00000X |
| License Number: | 052865 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Obstetrics & Gynecology |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |