Individual
DR. TROY O MAYDEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
216 S OAK ST, PRATT, KS 67124-2721
(620) 672-5934
(620) 672-3550
Mailing address
PO BOX 1024, PRATT, KS 67124-1024
(620) 672-5934
(620) 672-3550
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
14353
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100220930B
—
KS
01
—
410040206
RAILROAD MEDICARE
—
Enumeration date
11/28/2006
Last updated
06/12/2012
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