Provider Demographics
NPI:1437729670
Name:TROGNER, TREVOR NEIL (OD)
Entity Type:Individual
Prefix:DR
First Name:TREVOR
Middle Name:NEIL
Last Name:TROGNER
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 1:712 PARK LN
Mailing Address - Street 2:
Mailing Address - City:RADCLIFF
Mailing Address - State:KY
Mailing Address - Zip Code:40160-2329
Mailing Address - Country:US
Mailing Address - Phone:540-535-9119
Mailing Address - Fax:
Practice Address - Street 1:10337 DIXIE HWY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40272-3951
Practice Address - Country:US
Practice Address - Phone:502-916-7400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-29
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2248DT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist