Healthcare Provider Details

I. General information

NPI: 1457263956
Provider Name (Legal Business Name): DAVID TIMOTHY TROTTER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/19/2026
Last Update Date: 09/19/2026
Certification Date: 09/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4021 W WALNUT ST
ROGERS AR
72756-1842
US

IV. Provider business mailing address

227 S COURT ST
CARROLL IA
51401-3044
US

V. Phone/Fax

Practice location:
  • Phone: 402-957-7704
  • Fax:
Mailing address:
  • Phone: 402-957-7704
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: