Provider Demographics
NPI:1093855827
Name:MORGAN, TROY W (OD)
Entity Type:Individual
Prefix:DR
First Name:TROY
Middle Name:W
Last Name:MORGAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 S INDEPENDENCE BLVD STE 4
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23453-4776
Mailing Address - Country:US
Mailing Address - Phone:757-963-6304
Mailing Address - Fax:757-600-4191
Practice Address - Street 1:2020 S INDEPENDENCE BLVD STE 4
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23453-4776
Practice Address - Country:US
Practice Address - Phone:757-963-6304
Practice Address - Fax:757-600-4191
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618001629152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1093855827OtherANTHEM BCBS OF VA
VA1093855827Medicaid
VA1093855827Medicaid