Provider Demographics
NPI:1952556094
Name:TROSCLAIR, CHAD W (MD)
Entity Type:Individual
Prefix:
First Name:CHAD
Middle Name:W
Last Name:TROSCLAIR
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 1:5001 HIGHWAY 190 EAST SERVICE RD STE D5
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-4956
Mailing Address - Country:US
Mailing Address - Phone:985-377-2828
Mailing Address - Fax:
Practice Address - Street 1:5001 HIGHWAY 190 EAST SERVICE RD STE D5
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-4956
Practice Address - Country:US
Practice Address - Phone:985-377-2828
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-17
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS18116207QA0401X
LA024643207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine