Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | PO3472 | FL |
NPI | 1093963449 |
---|---|
Provider Name | Dr. Eric Stephen Trathen |
First Address | Fort Myers, FL 33907-3987 |
Second Address | Fort Myers, FL 33907-3987 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/08/2008 |
Last Update Date | 30/04/2020 |