Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 036106279 | IL |
Y | 207YP0228X | Pediatric Otolaryngology | 01063744A | IN |
NPI | 1427015833 |
---|---|
Provider Name | Dean J Trigg |
First Address | Indianapolis, IN 46268-3129 |
Second Address | Indianapolis, IN 46260-2053 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/04/2006 |
Last Update Date | 22/03/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A79242 | (02) |