Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207ND0101X | MOHS-Micrographic Surgeon | 109786 | FL |
N | 207ND0900X | Dermatopathologist | 109786 | FL |
N | 207NS0135X | Procedural Dermatology | 109786 | FL |
NPI | 1508092347 |
---|---|
Provider Name | James Scott Trimble |
First Address | Jacksonville, FL 32216-6241 |
Second Address | Jacksonville, FL 32216-6241 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2009 |
Last Update Date | 30/07/2014 |