Provider Demographics
NPI:1255429718
Name:UTLEY, TROY JOHN (TECHNICIAN)
Entity type:Individual
Prefix:
First Name:TROY
Middle Name:JOHN
Last Name:UTLEY
Suffix:
Gender:M
Credentials:TECHNICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 COAST GUARD BLVD
Mailing Address - Street 2:USCG ISC PORTSMOUTH
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23703-2199
Mailing Address - Country:US
Mailing Address - Phone:757-483-8474
Mailing Address - Fax:757-483-8475
Practice Address - Street 1:4000 COAST GUARD BLVD
Practice Address - Street 2:USCG ISC PORTSMOUTH
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23703-2199
Practice Address - Country:US
Practice Address - Phone:757-483-8474
Practice Address - Fax:757-483-8475
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other