Provider Demographics
NPI:1740778513
Name:TRANTHAM, DEAN HORACIO
Entity Type:Individual
Prefix:
First Name:DEAN
Middle Name:HORACIO
Last Name:TRANTHAM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 100174
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29202-3174
Mailing Address - Country:US
Mailing Address - Phone:864-897-8280
Mailing Address - Fax:864-897-8291
Practice Address - Street 1:111 W ROPER RD
Practice Address - Street 2:
Practice Address - City:EASLEY
Practice Address - State:SC
Practice Address - Zip Code:29640-8805
Practice Address - Country:US
Practice Address - Phone:864-897-8280
Practice Address - Fax:864-897-8281
Is Sole Proprietor?:No
Enumeration Date:2018-04-27
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC52683207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine