Provider Demographics
NPI:1114298817
Name:TRINITY INTERNAL MEDICINE AND SLEEP
Entity Type:Organization
Organization Name:TRINITY INTERNAL MEDICINE AND SLEEP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:W
Authorized Official - Last Name:LOCKLEAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-639-3330
Mailing Address - Street 1:895 E ANDREW JOHNSON HWY
Mailing Address - Street 2:
Mailing Address - City:GREENEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37745-3581
Mailing Address - Country:US
Mailing Address - Phone:423-639-3330
Mailing Address - Fax:423-639-3342
Practice Address - Street 1:895 E ANDREW JOHNSON HWY
Practice Address - Street 2:
Practice Address - City:GREENEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37745-3581
Practice Address - Country:US
Practice Address - Phone:423-639-3330
Practice Address - Fax:423-639-3342
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-26
Last Update Date:2013-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty