# KENNETH D TRUSCOTT JR.

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1134115082
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | MD036683E | PA | Yes |

## Other

- **Enumeration date:** 09/26/2005
- **Last updated:** 01/13/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0016888300001 | — | PA |
| 01 | — | 01925002 | CBC | — |
| 01 | — | 0378933000 | IBC | — |
| 01 | — | 560500 | HIGHMARK BLUE SHIELD | — |
| 01 | — | P003160 | GATEWAY | — |