Provider Demographics
NPI:1013017821
Name:STROTHER, MYRA (MD)
Entity Type:Individual
Prefix:DR
First Name:MYRA
Middle Name:
Last Name:STROTHER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4517 CEDAR RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66049-3804
Mailing Address - Country:US
Mailing Address - Phone:785-864-9500
Mailing Address - Fax:
Practice Address - Street 1:1200 SCHWEGLER DR
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66045-7559
Practice Address - Country:US
Practice Address - Phone:785-864-9500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-23632207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
A12615Medicare UPIN