Provider Demographics
NPI:1154396877
Name:ROSS, TROY WAYNE (MD)
Entity type:Individual
Prefix:DR
First Name:TROY
Middle Name:WAYNE
Last Name:ROSS
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Gender:M
Credentials:MD
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Mailing Address - Street 1:780 KUENZLI ST
Mailing Address - Street 2:STE 202
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-0845
Mailing Address - Country:US
Mailing Address - Phone:775-982-4590
Mailing Address - Fax:775-982-5496
Practice Address - Street 1:975 RYLAND ST
Practice Address - Street 2:STE 100
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-1667
Practice Address - Country:US
Practice Address - Phone:775-982-4754
Practice Address - Fax:775-982-4704
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2010-01-22
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Provider Licenses
StateLicense IDTaxonomies
CO373842083P0901X
NV132342083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
11998746OtherCAQH