Healthcare Provider Details

I. General information

NPI: 1700854122
Provider Name (Legal Business Name): ROBERT JAMES TROELL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/10/2006
Last Update Date: 07/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7975W SAHARA AVE 104
LAS VEGAS NV
89117-7916
US

IV. Provider business mailing address

7975W SAHARA AVE 104
LAS VEGAS NV
89117-7916
US

V. Phone/Fax

Practice location:
  • Phone: 702-242-6488
  • Fax:
Mailing address:
  • Phone: 702-242-6488
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0007X
TaxonomyPlastic Surgery within the Head & Neck (Otolaryngology) Physician
License Number99816
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: