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General NPI Number Information
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NPI Number | 1184030454
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Entity Type | Individual
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Provider Name | CAMERON TREGASKES D.O.
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Gender | Male
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Dates
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Enumeration Date | 07/08/2014
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Last Update Date | 08/31/2018
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Provider Practice Location Address
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Address Line | 2200 E SHOW LOW LAKE RD
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City | SHOW LOW
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State | AZ
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Zip | 85901
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Country | US
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Telephone | 928-537-6371
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Fax | 928-537-2538
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Provider Business Mailing Address
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Address Line | 8280 YANKEE ST
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City | CENTERVILLE
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State | OH
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Zip | 45458-1806
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Country | US
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Telephone | 937-436-4658
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 34.012135
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 007498
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License Number State | AZ
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