Provider Demographics
NPI:1285708511
Name:TRIMBLE FAMILY PRACTICE, LLC
Entity type:Organization
Organization Name:TRIMBLE FAMILY PRACTICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:KIM
Authorized Official - Middle Name:J
Authorized Official - Last Name:DEES
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:502-732-3230
Mailing Address - Street 1:PO BOX 247
Mailing Address - Street 2:470 HIGHWAY 421 N
Mailing Address - City:BEDFORD
Mailing Address - State:KY
Mailing Address - Zip Code:40006-0247
Mailing Address - Country:US
Mailing Address - Phone:502-255-7732
Mailing Address - Fax:502-255-3970
Practice Address - Street 1:470 HIGHWAY 421
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:KY
Practice Address - Zip Code:40006-0247
Practice Address - Country:US
Practice Address - Phone:502-255-7732
Practice Address - Fax:502-255-3970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY9423Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER