Provider Demographics
NPI:1245434059
Name:TROST, LANDON WESTLUND (MD)
Entity type:Individual
Prefix:
First Name:LANDON
Middle Name:WESTLUND
Last Name:TROST
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1443 W 800 N STE 302
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84057-2883
Mailing Address - Country:US
Mailing Address - Phone:801-655-0015
Mailing Address - Fax:801-655-0048
Practice Address - Street 1:1443 W 800 N STE 302
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84057-2883
Practice Address - Country:US
Practice Address - Phone:801-655-0015
Practice Address - Fax:801-655-0048
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN51000208800000X
LAMD.205248208800000X
UT10970793-1205208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2302558Medicaid
LA4R0396677Medicare PIN
MN340000997Medicare PIN