Individual
MR. TIMOTHY JOHN TROUPE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
882 M 72 NW, KALKASKA, MI 49646-8787
(231) 258-9781
(231) 258-0616
Mailing address
13385 PHELPS RD, CHARLEVOIX, MI 49720-9249
(269) 655-4014
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901003903
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4901003903
STATE LICENSE
MI
01
—
M39690004
MEDICARE PTAN
MI
Enumeration date
11/02/2006
Last updated
12/02/2011
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