Jefferson M Trupp MD PA

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

License

ME40682

Legal business name

JEFFERSON M TRUPP MD PA

Practice address

2900 S Highway 77
Lynn Haven, FL 32444-5612

Phone

(850) 481-1687

Fax

(850) 640-0761

NPI assigned

Jun 28, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jefferson M Trupp, MD

Title

Owner/Physician

Phone

(850) 481-1687

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1498608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1568983781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 S HIGHWAY 77",
            "city": "LYNN HAVEN",
            "state": "FL",
            "postal_code": "324445612",
            "telephone_number": "850-481-1687",
            "fax_number": "850-640-0761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 S HIGHWAY 77",
            "city": "LYNN HAVEN",
            "state": "FL",
            "postal_code": "324445612",
            "telephone_number": "850-481-1687",
            "fax_number": "850-640-0761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFERSON M TRUPP MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-28",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "TRUPP",
        "authorized_official_first_name": "JEFFERSON",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "850-481-1687",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": null,
            "license": "ME40682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Indenpendent Contractor for Counseling Services
• Kristopher D Isenberg
• Bilal Islam, M.D.
• Wendi W Jackson, SLP
• Eugene Roland Jalbert II, DO
• Matthew Leslie Jinks, PHARM.D.
• Thomas R. Johnson, M.D.
• Kendle Lashoan Jones
• Joseph M. Gerlecz, D.D.S., P.a.
• Kristen Kanaras

• Radiation Oncology Physician in Lynn Haven, FL
• Providers in Lynn Haven, FL by specialty
• Radiation Oncology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.