Individual
MR. TREVOR ADRIAN DANIEL GORMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1 MEDICAL PARK BLVD STE 400E, BRISTOL, TN 37620-7431
(423) 844-5400
Mailing address
1 MEDICAL PARK BLVD STE 400E, BRISTOL, TN 37620-7431
(423) 844-5400
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
5712
TN
363AM0700X
Medical Physician Assistant
5712
TN
363AS0400X
Surgical Physician Assistant
Primary
5712
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5712
STATE LICENSE
TN
Enumeration date
12/10/2009
Last updated
03/12/2024
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