Basic Information
| Provider Information | |||||||||
| NPI: | 1518221829 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | TRILLIUM FAMILY MEDICINE, PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 701 | ||||||||
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| City: | SYLVA | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287790701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8285876311 | ||||||||
| FaxNumber: | 8285868209 | ||||||||
| Practice Location | |||||||||
| Address1: | 3 DOCTORS PARK STE A | ||||||||
| Address2: | |||||||||
| City: | ASHEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 288014521 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8287728673 | ||||||||
| FaxNumber: | 8285868209 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/02/2012 | ||||||||
| LastUpdateDate: | 09/08/2020 | ||||||||
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| AuthorizedOfficialLastName: | WILLIAMS | ||||||||
| AuthorizedOfficialFirstName: | RHONDA | ||||||||
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| AuthorizedOfficialTitleorPosition: | CREDENTIALING COORDIANTOR | ||||||||
| AuthorizedOfficialTelephone: | 8283397257 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 09/08/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 184568 | NC | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.