Organization
THOMAS C TREVORROW
Active
Organization
THOMAS C TREVORROW
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS C TREVORROW M.D. (OWNER)
(724) 463-0286
Entity
Organization
Contact information
Practice address
119 PROFESSIONAL CTR, 1265 WAYNE AVENUE, STE. 203, INDIANA, PA 15701-3586
(724) 463-0286
(724) 463-3542
Mailing address
119 PROFESSIONAL CTR, 1265 WAYNE AVENUE, STE. 203, INDIANA, PA 15701-3586
(724) 463-0286
(724) 463-3542
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD049389L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007456850004
—
PA
01
—
111710
HIGHMARK GROUP
PA
01
—
735637
BLUE SHIELD PROVIDER
PR
01
—
735637-L3D
BLUESHIELD PROVIDER
PA
Enumeration date
01/16/2009
Last updated
08/17/2012
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