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NPI Code Detail

MEDICARE: ROBERT J DETROYE MD

MEDICARE: ROBERT J DETROYE MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207X00000XOrthopaedic Surgery Physician23453TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1437114956
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT J DETROYE MD
Provider Business Mailing Address
First Line : 2410 SUSANNAH ST
Second Line :
City : JOHNSON CITY
State : TN
Zip : 37601-1748
Country : US
Telephone Number : 423-282-9011
Fax Number : 423-282-0035
Provider Business Practice Location Address
First Line : 2410 SUSANNAH ST
Second Line :
City : JOHNSON CITY
State : TN
Zip : 37601-1748
Country : US
Telephone Number : 423-282-9011
Fax Number : 423-282-0035
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/18/2006
Last Update Date : 12/16/2019

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Directions to “ ROBERT J DETROYE MD” Practice Location

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