MEDICARE: DOMINICK TRINCA, M.D. PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician

General Provider Information

NPI Number	:	1053550236
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOMINICK TRINCA, M.D. PA

Provider Business Mailing Address
First Line	:	1440 HIGHWAY 1 S
Second Line	:
City	:	GREENVILLE
State	:	MS
Zip	:	38701-7140
Country	:	US
Telephone Number	:	662-820-4363
Fax Number	:

Provider Business Practice Location Address
First Line	:	1440 HIGHWAY 1 S
Second Line	:
City	:	GREENVILLE
State	:	MS
Zip	:	38701-7140
Country	:	US
Telephone Number	:	662-820-4363
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. DOMINICK TRINCA
Credential	:	M.D.
Telephone Number	:	662-820-4363

Provider Enumeration Date	:	02/12/2009
Last Update Date	:	02/12/2009

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