Provider Demographics
NPI:1710902184
Name:TROTTER, SAMUEL JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:JOSEPH
Last Name:TROTTER
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:101 FITNESS WAY
Mailing Address - Street 2:SUITE 2500
Mailing Address - City:ATHENS
Mailing Address - State:AL
Mailing Address - Zip Code:35611-2480
Mailing Address - Country:US
Mailing Address - Phone:256-262-2170
Mailing Address - Fax:256-216-1960
Practice Address - Street 1:101 FITNESS WAY
Practice Address - Street 2:SUITE 2500
Practice Address - City:ATHENS
Practice Address - State:AL
Practice Address - Zip Code:35611-2480
Practice Address - Country:US
Practice Address - Phone:256-262-2170
Practice Address - Fax:256-216-1960
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2015-02-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VT042-0007391208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology