MR. TROY TEAGARDIN PAC NPI 1619969243

NPI Information

NPI: 1619969243
Provider Name: MR. TROY TEAGARDIN, PAC
Classification: Physician Assistant - 363AS0400X
Entity Type: Individual

Specialization: Surgical

PECOS Registration: Yes

Address:
2500 NILES RD STE 6
SAINT JOSEPH, MI
ZIP 49085
Phone: (269) 408-1660
Get Directions

MR. Troy Teagardin, PAC is a surgical physician assistant in Saint Joseph, MI. MR. Troy Teagardin, PAC NPI is 1619969243. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2500 NILES RD STE 6
SAINT JOSEPH, MI
ZIP 49085-268
Phone: (269) 408-1660
Fax: (269) 408-1665

The NPI 1619969243 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 8/19/2005 and was last updated on 10/15/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AS0400X	Physician Assistant	Surgical	5601004173	MICHIGAN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0N97160	MEDICARE ID-TYPE UNSPECIFIED	MICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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