Provider Demographics
NPI:1528032794
Name:MOATS, TROY A (OD)
Entity Type:Individual
Prefix:DR
First Name:TROY
Middle Name:A
Last Name:MOATS
Suffix:
Gender:M
Credentials:OD
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Mailing Address - Street 1:12123 SHELBYVILLE RD
Mailing Address - Street 2:SUITE 100 #311
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40243-1079
Mailing Address - Country:US
Mailing Address - Phone:502-267-6567
Mailing Address - Fax:502-267-0055
Practice Address - Street 1:1401 ALLIANT AVE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40299-6372
Practice Address - Country:US
Practice Address - Phone:502-267-6567
Practice Address - Fax:502-267-0055
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY1665DT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN630022700Medicaid
MN630022700Medicaid