Provider Demographics
NPI:1528334992
Name:TRUSTED COMMUNITY PHYSICIANS
Entity type:Organization
Organization Name:TRUSTED COMMUNITY PHYSICIANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CLARENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:PODIATRIST
Authorized Official - Phone:313-685-7170
Mailing Address - Street 1:7140 W FORT ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48209-2917
Mailing Address - Country:US
Mailing Address - Phone:313-685-1208
Mailing Address - Fax:313-388-0593
Practice Address - Street 1:7140 W FORT ST
Practice Address - Street 2:SUITE 2
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48209-2917
Practice Address - Country:US
Practice Address - Phone:313-685-1208
Practice Address - Fax:313-388-0593
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-29
Last Update Date:2012-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty