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General NPI Number Information
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NPI Number | 1831543487
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Entity Type | Individual
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Provider Name | TRENTON WILLINGHAM M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/20/2016
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Last Update Date | 01/14/2025
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Provider Practice Location Address
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Address Line | 975 E 3RD ST # 376
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City | CHATTANOOGA
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State | TN
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Zip | 37403-2173
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Country | US
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Telephone | 423-778-7234
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Fax | 423-778-6811
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Provider Business Mailing Address
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Address Line | 975 E 3RD ST # 376
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City | CHATTANOOGA
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State | TN
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Zip | 37403-2173
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Country | US
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Telephone | 423-778-7234
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 62260
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | 62260
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License Number State | TN
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