Provider Demographics
NPI:1265599518
Name:TROMBLEY, JOSEPH A (PA)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:A
Last Name:TROMBLEY
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:115 WINWOOD DR
Mailing Address - Street 2:SUITE 105
Mailing Address - City:LEBANON
Mailing Address - State:TN
Mailing Address - Zip Code:37087-1340
Mailing Address - Country:US
Mailing Address - Phone:615-444-4126
Mailing Address - Fax:855-785-2890
Practice Address - Street 1:115 WINWOOD DR
Practice Address - Street 2:SUITE 105
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37087-1340
Practice Address - Country:US
Practice Address - Phone:615-444-4126
Practice Address - Fax:855-785-2890
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2017-02-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNPA0000000627363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4326617OtherBCBS OF TN
TN1508801Medicaid
TN620842749OtherHUMANA
TN3284468OtherUNITED HEALTHCARE
TNP01275147OtherR/R MEDICARE
TN620842749OtherHUMANA
TN103I970519Medicare PIN