Provider Demographics
NPI:1629063813
Name:STRICKLAND, R. DOUGLAS (MD)
Entity Type:Individual
Prefix:DR
First Name:R.
Middle Name:DOUGLAS
Last Name:STRICKLAND
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 1:135 W RAVINE RD
Mailing Address - Street 2:SUITE 3A
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37660-3847
Mailing Address - Country:US
Mailing Address - Phone:423-246-6777
Mailing Address - Fax:423-246-7766
Practice Address - Street 1:135 W RAVINE RD
Practice Address - Street 2:SUITE 3A
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37660-3847
Practice Address - Country:US
Practice Address - Phone:423-246-6777
Practice Address - Fax:423-246-7766
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD024405207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN000166210OtherBCBS OF TN
KY64259682Medicaid
KY000000053387OtherANTHEM
VA006076823Medicaid
TN100010825OtherPHP TENNCARE
VA252377OtherANTHEM BSG
TN3700033Medicaid
TN4675178OtherAETNA
WV0205997000Medicaid
VA084389OtherANTHEM FOR KPT
TNTN0105OtherUNITED HEALTHCARE RIVER V
VA100000216Medicare ID - Type UnspecifiedBSG
TN3700033Medicaid
TN000166210OtherBCBS OF TN
VA006076823Medicaid