Provider Demographics
NPI:1043279987
Name:TREECE, ROBERT NEIL III (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:NEIL
Last Name:TREECE
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 PARK ST
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42101-1708
Mailing Address - Country:US
Mailing Address - Phone:270-781-5111
Mailing Address - Fax:270-783-3750
Practice Address - Street 1:1211 ASHLEY CIR
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42104-3383
Practice Address - Country:US
Practice Address - Phone:270-782-8700
Practice Address - Fax:270-782-8704
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-20
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY10190A208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4100526OtherBCBS
TN1538173471OtherCOOKEVILLE PEDIATRIC ASSOCIATES NPI
TN1517710Medicaid
TNG99349Medicare UPIN
TN3898235Medicaid