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NPI Code Detail

MEDICARE: MR. TROY JAMES PREVOT PA

MEDICARE:  MR. TROY JAMES PREVOT  PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantPA.A10161.RXLA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1962437970
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. TROY JAMES PREVOT PA
Provider Business Mailing Address
First Line : 242 SHADY LAKE PL W
Second Line :
City : BATON ROUGE
State : LA
Zip : 70810-4332
Country : US
Telephone Number : 225-274-6760
Fax Number : 225-216-4299
Provider Business Practice Location Address
First Line : 2351 ENERGY DR
Second Line : SUITE 2000
City : BATON ROUGE
State : LA
Zip : 70808-2618
Country : US
Telephone Number : 225-274-6760
Fax Number : 225-216-4299
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2006
Last Update Date : 06/17/2012

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Directions to “ MR. TROY JAMES PREVOT PA” Practice Location

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