Healthcare Provider Details

I. General information

NPI: 1285708511
Provider Name (Legal Business Name): TRIMBLE FAMILY PRACTICE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

470 HIGHWAY 421
BEDFORD KY
40006-0247
US

IV. Provider business mailing address

PO BOX 247 470 HIGHWAY 421 N
BEDFORD KY
40006-0247
US

V. Phone/Fax

Practice location:
  • Phone: 502-255-7732
  • Fax: 502-255-3970
Mailing address:
  • Phone: 502-255-7732
  • Fax: 502-255-3970

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. KIM J DEES
Title or Position: CEO
Credential: RN
Phone: 502-732-3230