Individual
MR. TREY AMERSON PEGRAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
306 LANDRUM PLACE, CLARKSVILLE, TN 37043-4648
(931) 221-9544
(931) 444-5111
Mailing address
306 LANDRUM PLACE, CLARKSVILLE, TN 37043-4648
(931) 221-9544
(931) 444-5111
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Q2364
TX
207WX0200X
Ophthalmic Plastic and Reconstructive Surgery Physician
MD-55555
TN
207WX0200X
Ophthalmic Plastic and Reconstructive Surgery Physician
Primary
TN-55555
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q029682
—
TN
Enumeration date
05/09/2011
Last updated
08/14/2023
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