Provider Demographics
NPI:1033182050
Name:CARON, TROY HENRY (DO)
Entity Type:Individual
Prefix:DR
First Name:TROY
Middle Name:HENRY
Last Name:CARON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 S NEW BALLAS RD STE 5015B
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8270
Mailing Address - Country:US
Mailing Address - Phone:314-251-1826
Mailing Address - Fax:314-251-1827
Practice Address - Street 1:621 S NEW BALLAS RD STE 5015B
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-8270
Practice Address - Country:US
Practice Address - Phone:314-251-1826
Practice Address - Fax:314-251-1827
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2018-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS016905207X00000X
MO2007019176207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD072795400Medicaid
MO431560263OtherTRICARE WEST
MO1033182050Medicaid
AR166568003Medicaid
FL271719100Medicaid
PA102897372Medicaid
MO1033182050Medicaid
FL271719100Medicaid
PA102897372Medicaid
AR166568003Medicaid