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NPI Code Detail

MEDICARE: MRS. SHIRLEY D TRENTHAM MD

MEDICARE: MRS. SHIRLEY D TRENTHAM 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
12084P0800XPsychiatry PhysicianMD0000031650TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
14059342OTHERTNBLUE CROSS BLUE SHIELD
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1700877073
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SHIRLEY D TRENTHAM MD
Provider Business Mailing Address
First Line : 201 W SPRINGDALE AVE
Second Line :
City : KNOXVILLE
State : TN
Zip : 37917-5158
Country : US
Telephone Number : 865-637-9711
Fax Number : 865-637-1278
Provider Business Practice Location Address
First Line : 201 W SPRINGDALE AVE
Second Line :
City : KNOXVILLE
State : TN
Zip : 37917-5158
Country : US
Telephone Number : 865-637-9711
Fax Number : 865-637-1278
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/04/2005
Last Update Date : 12/08/2011

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Directions to “ MRS. SHIRLEY D TRENTHAM MD” Practice Location

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