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NPI Code Detail

MEDICARE: DR. RUDOLPH JOSEPH TRIANA JR. M.D.

MEDICARE: DR. RUDOLPH JOSEPH TRIANA JR. M.D.
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
1207YS0123XFacial Plastic Surgery PhysicianME92477FL
2207YX0905XOtolaryngology/Facial Plastic Surgery Physician36944KY

General Provider Information

NPI Number : 1811959661
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RUDOLPH JOSEPH TRIANA JR. M.D.
Provider Business Mailing Address
First Line : 1111 MEDICAL CENTER CIR
Second Line :
City : MAYFIELD
State : KY
Zip : 42066-1194
Country : US
Telephone Number : 270-251-4080
Fax Number :
Provider Business Practice Location Address
First Line : 1111 MEDICAL CENTER CIR
Second Line :
City : MAYFIELD
State : KY
Zip : 42066-1194
Country : US
Telephone Number : 270-251-4080
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/05/2006
Last Update Date : 09/22/2014

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