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Individual

JEFFERSON MASON TRUPP

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1410 MCFARLAND BLVD N, TUSCALOOSA, AL 35406-2459
(205) 345-8208
Mailing address
8203 N LAGOON DR, PANAMA CITY, FL 32408-5267
(850) 896-0773
(850) 234-9272

Taxonomy

Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
MD.11479
AL
2085R0001X
Radiation Oncology Physician
Primary
ME40682
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000014577
AL
05
266076800
FL
Enumeration date
03/21/2006
Last updated
12/02/2024
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