Provider Demographics
NPI:1376804682
Name:TROBAUGH, COREY ALLEN (DO)
Entity Type:Individual
Prefix:DR
First Name:COREY
Middle Name:ALLEN
Last Name:TROBAUGH
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:1481 W 10TH ST # 116A
Mailing Address - Street 2:RICHARD L ROUDEBUSH VA MEDICAL CENTER
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-2803
Mailing Address - Country:US
Mailing Address - Phone:317-988-4386
Mailing Address - Fax:
Practice Address - Street 1:1481 W 10TH ST # 116A
Practice Address - Street 2:RICHARD L. ROUDEBUSH VA MEDICAL CENTER
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-2803
Practice Address - Country:US
Practice Address - Phone:317-988-4386
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-04
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN02004858A2084P0800X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry