Individual
TRENT LORNE PRAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
550 REDMOND RD NW, ROME, GA 30165-1416
(706) 233-8508
(706) 233-8509
Mailing address
221 TECHNOLOGY PKWY NW, ROME, GA 30165-1369
(762) 235-1000
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
058103
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
057976876A
—
GA
Enumeration date
06/10/2006
Last updated
04/28/2020
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