Healthcare Provider Details
I. General information
NPI: 1215233887
Provider Name (Legal Business Name): JOSHUA ANTHONY TRINKLE P.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/31/2011
Last Update Date: 02/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
224 W. ERIE AVE
HARRISON AR
72601
US
IV. Provider business mailing address
224 W. ERIE AVE.
HARRISON AR
72601
US
V. Phone/Fax
- Phone: 870-741-8289
- Fax: 870-741-0308
- Phone: 870-741-8289
- Fax: 870-741-0308
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363AS0400X |
| Taxonomy | Surgical Physician Assistant |
| License Number | 2011002475 |
| License Number State | MO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: