MEDICARE: DR. TROY A. STURGILL D. C.

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
1	111N00000X	Chiropractor	3439	OK
2	111NR0400X	Rehabilitation Chiropractor	3439	OK

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	800522278	OTHER	OK	MEDICARE GROUP NUMBER

General Provider Information

NPI Number	:	1578560140
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TROY A. STURGILL D. C.

Provider Business Mailing Address
First Line	:	PO BOX 335
Second Line	:
City	:	WOODWARD
State	:	OK
Zip	:	73802-0335
Country	:	US
Telephone Number	:	580-256-1555
Fax Number	:	580-256-3370

Provider Business Practice Location Address
First Line	:	1209 9TH ST
Second Line	:
City	:	WOODWARD
State	:	OK
Zip	:	73801-3103
Country	:	US
Telephone Number	:	580-256-1555
Fax Number	:	580-256-3370

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/28/2005
Last Update Date	:	09/20/2023

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