MEDICARE: DR. TRENT MICHAEL HIPPARD D.C.

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	111N00000X	Chiropractor	038.011992	IL
2	111N00000X	Chiropractor	0000003312	TN

General Provider Information

NPI Number	:	1255602819
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TRENT MICHAEL HIPPARD D.C.

Provider Business Mailing Address
First Line	:	120 CAPITAL DR STE 103
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37922-3475
Country	:	US
Telephone Number	:	815-298-3667
Fax Number	:

Provider Business Practice Location Address
First Line	:	120 CAPITAL DR STE 103
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37922-3475
Country	:	US
Telephone Number	:	865-474-1479
Fax Number	:

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

Provider Enumeration Date	:	01/13/2012
Last Update Date	:	12/28/2021

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