Provider Demographics
NPI:1265455927
Name:STROHMEYER, KEVIN CHARLES (MD)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:CHARLES
Last Name:STROHMEYER
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 1:1406 TUSCULUM BLVD
Mailing Address - Street 2:MOB 2 SUITE 1000
Mailing Address - City:GREENEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37745-4332
Mailing Address - Country:US
Mailing Address - Phone:423-783-5510
Mailing Address - Fax:423-783-5515
Practice Address - Street 1:1406 TUSCULUM BLVD
Practice Address - Street 2:MOB 2 SUITE 1000
Practice Address - City:GREENEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37745-4332
Practice Address - Country:US
Practice Address - Phone:423-783-5510
Practice Address - Fax:423-783-5515
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2011-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN43755207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLI11876Medicare UPIN
FL43308ZMedicare ID - Type Unspecified