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NPI Code Detail

MEDICARE: DAVID HEATH TRAHAN MD

MEDICARE:   DAVID HEATH TRAHAN  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
1207Q00000XFamily Medicine Physician125.075220IL

General Provider Information

NPI Number : 1720649858
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID HEATH TRAHAN MD
Provider Business Mailing Address
First Line : 305 W JACKSON ST STE 200
Second Line :
City : CARBONDALE
State : IL
Zip : 62901-1474
Country : US
Telephone Number : 618-536-6621
Fax Number : 618-536-6621
Provider Business Practice Location Address
First Line : 8601 HILLSIDE RD
Second Line :
City : AMARILLO
State : TX
Zip : 79119-8032
Country : US
Telephone Number : 806-350-6805
Fax Number : 806-350-6806
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/28/2019
Last Update Date : 11/06/2025

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Directions to “ DAVID HEATH TRAHAN MD” Practice Location

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