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NPI Code Detail

MEDICARE: TRINITY EMERGENCY PHYSICIANS, LLC

MEDICARE: TRINITY EMERGENCY PHYSICIANS, LLC
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 PhysicianAL

General Provider Information

NPI Number : 1487669016
Entity Type Code : Organization
Provider Name (Legal Business Name) : TRINITY EMERGENCY PHYSICIANS, LLC
Provider Business Mailing Address
First Line : PO BOX 23485
Second Line :
City : BELFAST
State : ME
Zip : 04915-4485
Country : US
Telephone Number : 770-874-5400
Fax Number :
Provider Business Practice Location Address
First Line : 3690 GRANDVIEW PKWY
Second Line :
City : BIRMINGHAM
State : AL
Zip : 35243-3326
Country : US
Telephone Number : 205-971-1000
Fax Number : 770-874-5483
Authorized Official
Title or Position : DIRECTOR OF CREDENTIALING
Name : KIM H LARSEN
Credential :
Telephone Number : 770-874-5468
Provider Enumeration Date : 07/30/2006
Last Update Date : 02/05/2020

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Directions to “TRINITY EMERGENCY PHYSICIANS, LLC ” Practice Location

Language Start Address Practice Location
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