Peter a Trace, M.d.
NPI #1538364393 in Jacksonville, Illinois
Provider Information
- NPI Number
- 1538364393
- Entity Type
- Organization
- Organization Name
- Peter a Trace, M.d.
- Primary Specialty
- Obstetrics & Gynecology
- Enumeration Date
- Jun 20, 2007
- Last Updated
- Jun 1, 2009
Practice Location
- Address
- 1600 W WALNUT ST
- City
- Jacksonville
- State
- Illinois
- ZIP Code
- 62650-1136
- Phone
- (217) 243-8455
Authorized Official
- Name
- MR. PETER ALEXANDER TRACE, M.D.
- Title
- OWNER
- Phone
- (217) 243-8455
Specialties & Taxonomy Codes
| Specialty |
|---|
| Obstetrics & Gynecology |
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