Provider Demographics
NPI:1457458192
Name:RICHEY, TROY K (MD PC)
Entity Type:Individual
Prefix:
First Name:TROY
Middle Name:K
Last Name:RICHEY
Suffix:
Gender:M
Credentials:MD PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 S GARDEN WAY
Mailing Address - Street 2:STE 230
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-8187
Mailing Address - Country:US
Mailing Address - Phone:541-747-6159
Mailing Address - Fax:541-741-7249
Practice Address - Street 1:360 S GARDEN WAY
Practice Address - Street 2:STE 230
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-8187
Practice Address - Country:US
Practice Address - Phone:541-344-4168
Practice Address - Fax:458-201-8510
Is Sole Proprietor?:No
Enumeration Date:2006-09-17
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD20398207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR149989Medicaid
ORR114096Medicare PIN
OR149989Medicaid
G46459Medicare UPIN