Provider Demographics
NPI:1205833134
Name:JONES, TROY R (MD)
Entity Type:Individual
Prefix:
First Name:TROY
Middle Name:R
Last Name:JONES
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 1:2240 N 2ND ST
Mailing Address - Street 2:
Mailing Address - City:LANDER
Mailing Address - State:WY
Mailing Address - Zip Code:82520-9731
Mailing Address - Country:US
Mailing Address - Phone:307-332-0910
Mailing Address - Fax:307-332-3203
Practice Address - Street 1:2240 N 2ND ST
Practice Address - Street 2:
Practice Address - City:LANDER
Practice Address - State:WY
Practice Address - Zip Code:82520-9731
Practice Address - Country:US
Practice Address - Phone:307-332-0910
Practice Address - Fax:307-332-3203
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-07
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY7420A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0400211-00Medicaid
WYP00454974OtherRAILROAD MEDICARE
FL53748ZMedicare UPIN