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General NPI Number Information
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NPI Number | 1548098163
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Entity Type | Individual
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Provider Name | JACK TROLLINGER
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Gender | Male
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Dates
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Enumeration Date | 07/24/2024
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Last Update Date | 01/29/2026
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Provider Practice Location Address
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Address Line | 830 S GLOSTER ST
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City | TUPELO
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State | MS
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Zip | 38801-4934
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Country | US
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Telephone | 662-377-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 116 CYDELL DR
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City | BALDWYN
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State | MS
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Zip | 38824-9204
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Country | US
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Telephone |
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 902028
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License Number State | MS
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