Individual
SAMANTHA KILIA TROUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3535 SOUTHERN BLVD, KETTERING, OH 45429-1221
(808) 294-9379
Mailing address
3131 NEWMARK DR STE 220, MIAMISBURG, OH 45342-5400
(937) 436-4658
(937) 436-4984
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
50.005278RX
OH
363A00000X
Physician Assistant
Primary
50.005278RX
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0249173
—
OH
Enumeration date
10/11/2017
Last updated
09/16/2020
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