Healthcare Provider Details

I. General information

NPI: 1720547904
Provider Name (Legal Business Name): COLLIN MICHAEL TROESTER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2019
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6161 S YALE AVE
TULSA OK
74136-1902
US

IV. Provider business mailing address

PO BOX 4930
TULSA OK
74159-0930
US

V. Phone/Fax

Practice location:
  • Phone: 918-743-8838
  • Fax: 918-743-8552
Mailing address:
  • Phone: 918-743-8838
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number45062
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: