Provider Demographics
NPI:1447357892
Name:COMSTOCK, TROY (MD)
Entity type:Individual
Prefix:DR
First Name:TROY
Middle Name:
Last Name:COMSTOCK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7351 E OSBORN RD
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-6451
Mailing Address - Country:US
Mailing Address - Phone:480-882-4335
Mailing Address - Fax:480-882-5705
Practice Address - Street 1:7400 E THOMPSON PEAK PKWY
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-4109
Practice Address - Country:US
Practice Address - Phone:480-324-7004
Practice Address - Fax:480-324-7010
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO36505174400000X
AZ36913207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No174400000XOther Service ProvidersSpecialist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01365055Medicaid
AZ1447357892Medicaid
COG61771Medicare UPIN
464468Medicare ID - Type Unspecified
CO809127Medicare PIN
CO01365055Medicaid