MEDICARE: DR. JAYME ERIKA TREVINO MD

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	207VC0300X	Complex Family Planning Physician	14223979-1205	UT
2	207V00000X	Obstetrics & Gynecology Physician	2022010565	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093209082
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAYME ERIKA TREVINO MD

Provider Business Mailing Address
First Line	:	PO BOX 60352
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63160-0352
Country	:	US
Telephone Number	:	314-362-4211
Fax Number	:	888-315-6494

Provider Business Practice Location Address
First Line	:	4901 FOREST PARK AVE
Second Line	:	DIV OBGYN FAMILY PLANNING, STE 710
City	:	SAINT LOUIS
State	:	MO
Zip	:	63108-1495
Country	:	US
Telephone Number	:	314-362-4211
Fax Number	:	888-315-6494

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/21/2018
Last Update Date	:	12/31/2025

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