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NPI Code Detail

MEDICARE: ROBERT WILLIAM THRAILKILL MD

MEDICARE: ROBERT WILLIAM THRAILKILL 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
1207P00000XEmergency Medicine PhysicianG73114CA

Other Identifiers

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

General Provider Information

NPI Number : 1437267135
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT WILLIAM THRAILKILL MD
Provider Business Mailing Address
First Line : 3928 WAYNESBORO CT
Second Line :
City : STOCKTON
State : CA
Zip : 95219-3222
Country : US
Telephone Number : 209-541-6406
Fax Number :
Provider Business Practice Location Address
First Line : 520 WEST 'I' STREET
Second Line :
City : LOS BANOS
State : CA
Zip : 93635-3419
Country : US
Telephone Number : 209-826-0591
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/25/2006
Last Update Date : 03/16/2011

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