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General NPI Number Information
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NPI Number | 1497797948
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Entity Type | Organization
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Legal Business Name | MICHAEL R. TRIMBLE M.D., F.A.C.S
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Dates
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Enumeration Date | 06/11/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1514 GOLDRUSH RD STE. A-18
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City | BULLHEAD CITY
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State | AZ
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Zip | 86442-8375
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Country | US
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Telephone | 928-704-6070
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Fax |
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Provider Business Mailing Address
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Address Line | 1514 GOLDRUSH RD STE. A-18
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City | BULLHEAD CITY
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State | AZ
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Zip | 86442-8375
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Country | US
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Telephone | 928-704-6070
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Fax |
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Authorized Official
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Title or Position | GENERAL SURGEON
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Name | MICHAEL ROBERT TRIMBLE
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Credential | M.D.
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Telephone | 928-704-6070
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 33104
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License Number State | AZ
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