Provider Demographics
NPI:1366636839
Name:LEXINGTON FAMILY PRACTICE LLC
Entity Type:Organization
Organization Name:LEXINGTON FAMILY PRACTICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:H
Authorized Official - Last Name:STROUP
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:731-307-8095
Mailing Address - Street 1:447 SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:TN
Mailing Address - Zip Code:38351-1637
Mailing Address - Country:US
Mailing Address - Phone:731-307-8095
Mailing Address - Fax:
Practice Address - Street 1:447 SUNSET DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:TN
Practice Address - Zip Code:38351-1637
Practice Address - Country:US
Practice Address - Phone:731-307-8095
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-28
Last Update Date:2007-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000023810207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty