Healthcare Provider Details

I. General information

NPI: 1598749632
Provider Name (Legal Business Name): DAVID TRINKLE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2005
Last Update Date: 08/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 CRYSTAL SPRING AVE SW SUITE 302
ROANOKE VA
24014-2462
US

IV. Provider business mailing address

213 S JEFFERSON ST SUITE 625
ROANOKE VA
24011-1700
US

V. Phone/Fax

Practice location:
  • Phone: 540-981-7653
  • Fax: 540-981-7469
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number0101-042871
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: