Healthcare Provider Details

I. General information

NPI: 1326933953
Provider Name (Legal Business Name): WILLIAM TYLER TROY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2025
Last Update Date: 06/12/2025
Certification Date: 06/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5121 S COTTONWOOD ST
MURRAY UT
84107-5701
US

IV. Provider business mailing address

8693 S HIDDEN OAKS CIR
COTTONWOOD HEIGHTS UT
84121-6126
US

V. Phone/Fax

Practice location:
  • Phone: 801-507-7000
  • Fax:
Mailing address:
  • Phone: 317-774-4713
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number12042650-3102
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: