Provider Demographics
NPI:1255467817
Name:TRIKHA, AJIT (MD)
Entity Type:Individual
Prefix:
First Name:AJIT
Middle Name:
Last Name:TRIKHA
Suffix:
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 1:931 LAFITE CT
Mailing Address - Street 2:
Mailing Address - City:TOWN AND COUNTRY
Mailing Address - State:MO
Mailing Address - Zip Code:63017-8311
Mailing Address - Country:US
Mailing Address - Phone:636-256-0627
Mailing Address - Fax:636-386-2448
Practice Address - Street 1:931 LAFITE CT
Practice Address - Street 2:
Practice Address - City:TOWN AND COUNTRY
Practice Address - State:MO
Practice Address - Zip Code:63017-8311
Practice Address - Country:US
Practice Address - Phone:636-256-0627
Practice Address - Fax:636-386-2448
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR8J252084P0800X
IL2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL211168Medicare ID - Type UnspecifiedTRX HEALTH SYSTEMS PC
ILK15447Medicare ID - Type UnspecifiedTRX HEALTH SYSTEMS PC
ILE12107Medicare UPIN
IL982521Medicare ID - Type UnspecifiedINDIVIDUAL