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NPI Code Detail

MEDICARE: STEPHAN N TRENT DO

MEDICARE: STEPHAN N TRENT DO
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
1207Q00000XFamily Medicine Physician6669AWY

Other Identifiers

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

General Provider Information

NPI Number : 1972546851
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHAN N TRENT DO
Provider Business Mailing Address
First Line : 1522 E A ST
Second Line :
City : CASPER
State : WY
Zip : 82601-2217
Country : US
Telephone Number : 307-233-6000
Fax Number : 307-473-1284
Provider Business Practice Location Address
First Line : 1522 E A ST
Second Line :
City : CASPER
State : WY
Zip : 82601-2217
Country : US
Telephone Number : 307-233-6000
Fax Number : 307-473-1284
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2006
Last Update Date : 04/09/2012

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Directions to “ STEPHAN N TRENT DO” Practice Location

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