Provider Demographics
NPI:1851344204
Name:MCKAY, TROY D (OD)
Entity Type:Individual
Prefix:
First Name:TROY
Middle Name:D
Last Name:MCKAY
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 1:1836 SOUTH AVE
Mailing Address - Street 2:
Mailing Address - City:LA CROSSE
Mailing Address - State:WI
Mailing Address - Zip Code:54601-5429
Mailing Address - Country:US
Mailing Address - Phone:608-342-2020
Mailing Address - Fax:608-342-6330
Practice Address - Street 1:407 S MAIN ST
Practice Address - Street 2:
Practice Address - City:VIROQUA
Practice Address - State:WI
Practice Address - Zip Code:54665-2100
Practice Address - Country:US
Practice Address - Phone:608-673-8281
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2014-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2818-035152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI7813OtherDEAN HEALTH INSURANCE
WI1040959OtherPHYSICIANS PLUS
WI38610100Medicaid
WI7813OtherDEAN HEALTH INSURANCE
U80817Medicare UPIN
WI38610100Medicaid