Trevillyan, M Jeanine
Trevillyan, M Jeanine is an sole proprietor health care provider with primary practice located at 501 Walnut Street Correctional Medical Services, Texarkana AR 71854-0809. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Emergency Medicine. Allopathic & Osteopathic Physicians / Emergency Medicine is her primary health care specialty. Trevillyan, M Jeanine can be contacted via phone (870) 216-1256.Contact Information
Primary practice address
501 Walnut Street Correctional Medical Services
Texarkana AR 71854-0809
Phone: (870) 216-1256
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | E-0884 | Arkansas |
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | E-0884 | Arkansas |
Profile Details
| NPI number | 1801958145 |
|---|---|
| LBN Legal business name | Trevillyan, M Jeanine |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 14th, 2006 |
| Last updated | Nov 16th, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1801958145 | NPPES |
| Arkansas | MEDICAID | 129861001 |
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