Individual
DR. ORIN PAUL TRENTHAM III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1808 W MAIN ST, RUSSELLVILLE, AR 72801-2724
(479) 968-2841
Mailing address
5515 IMPALA DR, JOPLIN, MO 64804-8293
(417) 540-1036
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
106911
MO
207R00000X
Internal Medicine Physician
E-12463
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100165470B
—
KS
05
—
100181910A
—
OK
01
—
110111900
RR MEDICARE
—
05
—
207744806
—
MO
01
—
9296
ANTHEM
MO
Enumeration date
06/19/2006
Last updated
12/13/2021
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