Provider Demographics
NPI:1184630154
Name:CHILD, TROY REX (MD)
Entity Type:Individual
Prefix:
First Name:TROY
Middle Name:REX
Last Name:CHILD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3340 NORTH CENTER ST #800
Mailing Address - Street 2:
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-7406
Mailing Address - Country:US
Mailing Address - Phone:801-990-1911
Mailing Address - Fax:801-990-1912
Practice Address - Street 1:4401 HARRISON BOULEVARD
Practice Address - Street 2:MCKAY DEE HOSPITAL
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84403
Practice Address - Country:US
Practice Address - Phone:801-387-2800
Practice Address - Fax:801-733-5618
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT97-343134-1205207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT1502954OtherUMWA
UT870545614CH3OtherEDUCATORS MUTUAL
UT2090168OtherUNITED HEALTHCARE
UT8597445OtherWORKERS COMP FUND
UT10326OtherHEALTHY U
ID805668400Medicaid
AZ822157Medicaid
UTPRA02408OtherMOLINA
NV100501275Medicaid
UT107008033101OtherIHC
WY114801000Medicaid
UT310746OtherDESERET MUTUAL
UT44544OtherPEHP
UTQM0000075886OtherALTIUS
ID805668400Medicaid
UT107008033101OtherIHC
AZ822157Medicaid