Provider Demographics
NPI:1790826741
Name:TROON FAMILY AND PREVENTATIVE CARE, PLLC
Entity Type:Organization
Organization Name:TROON FAMILY AND PREVENTATIVE CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:EVAN
Authorized Official - Middle Name:SCOT
Authorized Official - Last Name:TROST
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-419-1687
Mailing Address - Street 1:10025 E DYNAMITE BLVD
Mailing Address - Street 2:SUITE 155
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85262-3688
Mailing Address - Country:US
Mailing Address - Phone:480-419-1687
Mailing Address - Fax:
Practice Address - Street 1:10025 E DYNAMITE BLVD
Practice Address - Street 2:SUITE 155
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85262-3688
Practice Address - Country:US
Practice Address - Phone:480-419-1687
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ32075207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZI09111Medicare UPIN