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General NPI Number Information
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NPI Number | 1114298817
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Entity Type | Organization
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Legal Business Name | TRINITY INTERNAL MEDICINE AND SLEEP
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Dates
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Enumeration Date | 01/26/2012
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Last Update Date | 03/18/2013
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Provider Practice Location Address
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Address Line | 895 E ANDREW JOHNSON HWY
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City | GREENEVILLE
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State | TN
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Zip | 37745-3581
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Country | US
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Telephone | 423-639-3330
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Fax | 423-639-3342
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Provider Business Mailing Address
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Address Line | 895 E ANDREW JOHNSON HWY
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City | GREENEVILLE
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State | TN
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Zip | 37745-3581
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Country | US
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Telephone | 423-639-3330
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Fax | 423-639-3342
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Authorized Official
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Title or Position | OWNER
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Name | ROBERT W LOCKLEAR
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Credential |
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Telephone | 423-639-3330
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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