Provider Demographics
NPI:1306042957
Name:KOCH, TROY STEVEN (MD)
Entity Type:Individual
Prefix:
First Name:TROY
Middle Name:STEVEN
Last Name:KOCH
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 1:1308 E 900 S STE C
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-8730
Mailing Address - Country:US
Mailing Address - Phone:356-732-3014
Mailing Address - Fax:
Practice Address - Street 1:500 S UNIVERSITY AVE
Practice Address - Street 2:SUITE #101
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-5302
Practice Address - Country:US
Practice Address - Phone:501-664-3914
Practice Address - Fax:501-664-5246
Is Sole Proprietor?:No
Enumeration Date:2007-06-21
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6592058-12052085R0202X
NC2010-018122085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5922695Medicaid
NC5922695Medicaid
HIVAD000Medicare UPIN