Provider Demographics
NPI:1821018284
Name:STRATIENKO, ALEXANDER A (MD)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:A
Last Name:STRATIENKO
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:PO BOX 306
Mailing Address - Street 2:
Mailing Address - City:LOOKOUT MOUNTAIN
Mailing Address - State:TN
Mailing Address - Zip Code:37350-0306
Mailing Address - Country:US
Mailing Address - Phone:423-693-2400
Mailing Address - Fax:423-693-2499
Practice Address - Street 1:1032 MCCALLIE AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37403
Practice Address - Country:US
Practice Address - Phone:423-693-2400
Practice Address - Fax:423-693-2499
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN024470207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009953130Medicaid
610225400OtherFEDERAL BLACK LUNG
014000521OtherCIGNA
060058390OtherRAILROAD MEDICARE
TN3078814Medicaid
TN3144167OtherTENNESSEE BCBS
TN3020817OtherMEMORIAL HEALTH SYSTEM
GA000580049CMedicaid
4336171OtherAETNA US HEALTHCARE
GA52794073OtherGEORGIA BCBS
610225400OtherFEDERAL BLACK LUNG
GA52794073OtherGEORGIA BCBS