Provider Demographics
NPI:1053517359
Name:SOFINOWSKI, TROY MICHAEL (MD)
Entity type:Individual
Prefix:
First Name:TROY
Middle Name:MICHAEL
Last Name:SOFINOWSKI
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1272 GARRISON DR
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-2598
Mailing Address - Country:US
Mailing Address - Phone:615-867-8060
Mailing Address - Fax:615-893-2890
Practice Address - Street 1:5000 KY ROUTE 321 STE 2162
Practice Address - Street 2:
Practice Address - City:PRESTONSBURG
Practice Address - State:KY
Practice Address - Zip Code:41653-9113
Practice Address - Country:US
Practice Address - Phone:606-889-6185
Practice Address - Fax:606-889-6186
Is Sole Proprietor?:No
Enumeration Date:2007-06-23
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK25735208600000X
TN48132208800000X
KY48421208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100491170Medicaid