# TRUSTEES OF TRINITY COLLEGE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Trinity College Sports Medicine
- **Organization subpart:** No

## Provider details

- **NPI number:** 1891196309
- **Authorized official:** MICHAEL D. RENWICK (DIRECTOR OF ATHLETICS)
- **Authorized official phone:** (860) 297-2055

## Contact information

- **Practice address:** 300 SUMMIT ST, FERRIS ATHLETIC CENTER, HARTFORD, CT 06106-3100
- **Practice address phone:** (860) 297-2575
- **Mailing address:** 5050 SPRING VALLEY RD, DALLAS, TX 75244-3995
- **Mailing address phone:** (800) 555-9073
- **Mailing address fax:** (972) 367-3452

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207QS0010X | Sports Medicine (Family Medicine) Physician | — | NULL | — |
| 207QS0010X | Sports Medicine (Family Medicine) Physician | — | — | — |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |
| 207XX0005X | Sports Medicine (Orthopaedic Surgery) Physician | — | NULL | — |
| 207XX0005X | Sports Medicine (Orthopaedic Surgery) Physician | — | — | — |

## Other

- **Enumeration date:** 09/16/2014
- **Last updated:** 10/16/2014