Provider Demographics
NPI:1417531419
Name:FLOOD, TREVOR A (MD)
Entity Type:Individual
Prefix:
First Name:TREVOR
Middle Name:A
Last Name:FLOOD
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 1:5100 TALLEY RD STE 300
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72204-8040
Mailing Address - Country:US
Mailing Address - Phone:501-500-6640
Mailing Address - Fax:501-500-6681
Practice Address - Street 1:2889 W ASHTON BLVD STE 300
Practice Address - Street 2:
Practice Address - City:LEHI
Practice Address - State:UT
Practice Address - Zip Code:84043-4968
Practice Address - Country:US
Practice Address - Phone:501-500-6640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-06
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12062587-1205207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology