Healthcare Provider Details

I. General information

NPI: 1730156985
Provider Name (Legal Business Name): THOMAS C TROTTA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2006
Last Update Date: 04/23/2021
Certification Date: 04/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 GOETHALS DRIVE STE D KADLEC CLINIC GENERAL SURGERY
RICHLAND WA
99352
US

IV. Provider business mailing address

800 SWIFT BLVD STE 300
RICHLAND WA
99352
US

V. Phone/Fax

Practice location:
  • Phone: 509-942-3185
  • Fax: 509-946-1850
Mailing address:
  • Phone: 509-942-3627
  • Fax: 509-942-2268

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD00023082
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: