Individual
DR. KENNETH JOHN TROXCLAIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1000 HEALTH CENTER DR, MATTOON, IL 61938-4644
(217) 258-2397
(217) 258-2107
Mailing address
PO BOX 372, MATTOON, IL 61938-0372
(217) 258-2581
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036-171606
IL
2084P0800X
Psychiatry Physician
17887
ND
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/17/2019
Last updated
09/18/2024
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