Provider Demographics
NPI:1790112340
Name:MCCORMICK, TREVOR WILLIAM (DVM)
Entity Type:Individual
Prefix:DR
First Name:TREVOR
Middle Name:WILLIAM
Last Name:MCCORMICK
Suffix:
Gender:M
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5288 US HIGHWAY 89 S
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:MT
Mailing Address - Zip Code:59047-9133
Mailing Address - Country:US
Mailing Address - Phone:406-222-1700
Mailing Address - Fax:406-222-1729
Practice Address - Street 1:5288 US HIGHWAY 89 S
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:MT
Practice Address - Zip Code:59047-9133
Practice Address - Country:US
Practice Address - Phone:406-222-1700
Practice Address - Fax:406-222-1729
Is Sole Proprietor?:No
Enumeration Date:2013-09-27
Last Update Date:2013-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT2007174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian