MEDICARE: MICHAEL COHRON TROTTER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	07481R	LA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00214993	OTHER	LA	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518964535
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL COHRON TROTTER MD

Provider Business Mailing Address
First Line	:	PO BOX 4739
Second Line	:
City	:	GREENVILLE
State	:	MS
Zip	:	38704-4739
Country	:	US
Telephone Number	:	662-725-2749
Fax Number	:	662-725-2741

Provider Business Practice Location Address
First Line	:	1705 HOSPITAL ST
Second Line	:
City	:	GREENVILLE
State	:	MS
Zip	:	38703-3225
Country	:	US
Telephone Number	:	662-335-6703
Fax Number	:	662-335-6705

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/05/2005
Last Update Date	:	05/25/2010

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