Provider Demographics
NPI:1740509801
Name:TROUTWINE, BETHANY R (MD)
Entity type:Individual
Prefix:
First Name:BETHANY
Middle Name:R
Last Name:TROUTWINE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8545 SMITHFIELD LN
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46237-9163
Mailing Address - Country:US
Mailing Address - Phone:317-556-3317
Mailing Address - Fax:
Practice Address - Street 1:8545 SMITHFIELD LN
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46237-9163
Practice Address - Country:US
Practice Address - Phone:317-556-3317
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-27
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01070941A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine