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General NPI Number Information
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NPI Number | 1790826741
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Entity Type | Organization
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Legal Business Name | TROON FAMILY AND PREVENTATIVE CARE, PLLC
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Dates
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Enumeration Date | 02/11/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 10025 E DYNAMITE BLVD SUITE 155
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City | SCOTTSDALE
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State | AZ
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Zip | 85262-3688
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Country | US
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Telephone | 480-419-1687
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Fax |
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Provider Business Mailing Address
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Address Line | 10025 E DYNAMITE BLVD SUITE 155
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City | SCOTTSDALE
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State | AZ
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Zip | 85262-3688
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Country | US
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Telephone | 480-419-1687
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Fax |
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | DR. EVAN SCOT TROST
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Credential | M.D.
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Telephone | 480-419-1687
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 32075
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License Number State | AZ
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