Provider Demographics
NPI:1770859639
Name:TRIMBLE, MICHAEL J (PA-C)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:J
Last Name:TRIMBLE
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:1008 KELSEY GLEN DR
Mailing Address - Street 2:
Mailing Address - City:MT JULIET
Mailing Address - State:TN
Mailing Address - Zip Code:37122-8562
Mailing Address - Country:US
Mailing Address - Phone:615-260-5884
Mailing Address - Fax:615-320-3259
Practice Address - Street 1:40 W CALDWELL ST STE 100
Practice Address - Street 2:
Practice Address - City:MOUNT JULIET
Practice Address - State:TN
Practice Address - Zip Code:37122-3180
Practice Address - Country:US
Practice Address - Phone:615-773-2712
Practice Address - Fax:615-773-2707
Is Sole Proprietor?:No
Enumeration Date:2012-03-26
Last Update Date:2024-02-05
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Provider Licenses
StateLicense IDTaxonomies
TN1127723363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant