Individual
TROY SLADE FORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
411 S BEELINE HWY, SUITE A, PAYSON, AZ 85541-4892
(928) 474-3556
(928) 474-3161
Mailing address
411 S BEELINE HWY, SUITE A, PAYSON, AZ 85541-4892
(928) 474-3556
(928) 474-3161
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD790
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101254-01
—
AZ
01
—
1275722498
DMERC
AZ
Enumeration date
11/09/2006
Last updated
04/07/2008
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