Individual
TREVOR LEE TATUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
700 19TH ST S, BIRMINGHAM, AL 35233-1927
(205) 933-8101
Mailing address
525 WILD RIDGE CIR, PELHAM, AL 35124-2528
(706) 594-8563
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
1909
AL
Other
Enumeration date
01/25/2022
Last updated
01/25/2022
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