| Jeremy Blake Trull, | |
|
101 Sivley Rd Sw, Huntsville, AL 35801-4470 | |
| (256) 265-0000 | |
| Not Available |
| Full Name | Jeremy Blake Trull |
|---|---|
| Gender | Male |
| Speciality | Registered Nurse |
| Location | 101 Sivley Rd Sw, Huntsville, Alabama |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902677859 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 163W00000X | Registered Nurse | 1-176633 (Alabama) | Primary |
| Entity Name | Sportsmed Orthopaedic Specialists |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1508947839 PECOS PAC ID: 7214903723 Enrollment ID: O20040907000749 |
| Mailing Address | Practice Location Address |
|---|---|
| Jeremy Blake Trull, 2106 Buckingham Dr Sw, Huntsville, AL 35803-2018 Ph: (256) 400-9444 | Jeremy Blake Trull, 101 Sivley Rd Sw, Huntsville, AL 35801-4470 Ph: (256) 265-0000 |
Brittany Dixon, RN Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 4040 Memorial Pkwy Sw, Huntsville, AL 35802 Phone: 256-533-1970 Fax: 256-705-6475 | |
Janey Bloom Taylor, NP Registered Nurse Medicare: Accepting Medicare Assignments Practice Location: 245 Governors Dr Se, Huntsville, AL 35801 Phone: 256-265-1000 | |
Tiffany Sanders, Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 4040 Memorial Pkwy Sw, Huntsville, AL 35802 Phone: 256-533-1970 | |
Kasey Galentine, RN Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 4040 Memorial Pkwy Sw, Huntsville, AL 35802 Phone: 256-734-4688 | |
Mrs. Kristina Bonds Chapman, CRNP Registered Nurse Medicare: Accepting Medicare Assignments Practice Location: 1 Hospital Dr Sw, #202, Huntsville, AL 35801 Phone: 256-429-5285 | |
Alexa West Gentle, RN-BSN Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 4040 Memorial Pkwy Sw, Huntsville, AL 35802 Phone: 256-533-1970 | |
Dr. Lutisha Crawford, PMHNP-BC, DIPACLM Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 4100 Goss Rd Sw, Huntsville, AL 35809 Phone: 256-955-8888 |