Provider Demographics
NPI:1922303866
Name:FLAMING, TRENT EVAN
Entity Type:Individual
Prefix:MR
First Name:TRENT
Middle Name:EVAN
Last Name:FLAMING
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 1:10325 ABERDEEN DR
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-7690
Mailing Address - Country:US
Mailing Address - Phone:580-515-3172
Mailing Address - Fax:
Practice Address - Street 1:10325 ABERDEEN DR
Practice Address - Street 2:
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099-7690
Practice Address - Country:US
Practice Address - Phone:580-515-3172
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-25
Last Update Date:2011-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1980363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant