Healthcare Provider Details

I. General information

NPI: 1487763827
Provider Name (Legal Business Name): TROY P COON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 02/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3651 WHEELER ROAD
AUGUSTA GA
30909
US

IV. Provider business mailing address

P.O. BOX 3638 1125 TROUPE STREET
AUGUSTA GA
30914-3638
US

V. Phone/Fax

Practice location:
  • Phone: 706-651-2369
  • Fax: 706-651-2364
Mailing address:
  • Phone: 706-737-4575
  • Fax: 706-731-5289

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number056422
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: