Provider Demographics
NPI:1346229515
Name:STROUP, KEVIN H (MD)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:H
Last Name:STROUP
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 1:200 W CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:TN
Mailing Address - Zip Code:38351-2038
Mailing Address - Country:US
Mailing Address - Phone:731-968-3646
Mailing Address - Fax:731-968-1870
Practice Address - Street 1:200 W CHURCH ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:TN
Practice Address - Zip Code:38351-2038
Practice Address - Country:US
Practice Address - Phone:731-968-3646
Practice Address - Fax:731-968-1870
Is Sole Proprietor?:No
Enumeration Date:2006-01-16
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN23810207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNTN0102OtherAMERICHOICE
TN184234OtherUNISON
TN484925OtherMULTIPLAN
TN184234OtherBETTER HEALTH PLAN OF TN
TN3835292Medicaid
TN610916101OtherUS DEPT. OF LABOR
TN4117685OtherBCBS
TN8167952OtherCIGNA
TN36935OtherTLC
TN184234OtherBETTER HEALTH PLAN OF TN
TN36935OtherTLC
TN3835292Medicaid
TN103I081491Medicare PIN
TN3835290Medicare PIN