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General NPI Number Information
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NPI Number | 1881677821
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Entity Type | Individual
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Provider Name | TRENT L. HOVENGA MD
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Gender | Male
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Dates
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Enumeration Date | 11/23/2005
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Last Update Date | 01/19/2021
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Provider Practice Location Address
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Address Line | 110 RUGELY CT
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City | COLORADO SPGS
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State | CO
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Zip | 80906-5954
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Country | US
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Telephone | 719-475-7777
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Fax | 719-694-3565
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Provider Business Mailing Address
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Address Line | 110 RUGELY CT
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City | COLORADO SPGS
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State | CO
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Zip | 80906-5954
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Country | US
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Telephone | 719-475-7777
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Fax | 719-694-3565
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 27788
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License Number State | CO
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