Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RX0202X | Medical Oncology | MD19268 | OR |
N | 2086X0206X | Surgical Oncologist | MD19268 | OR |
NPI | 1295826014 |
---|---|
Provider Name | Thomas Patrick Trezona |
First Address | Springfield, OR 97477-1025 |
Second Address | Springfield, OR 97477-1025 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2006 |
Last Update Date | 16/09/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
076802 | (05) | OR |
E93585 | (02) |