Provider Demographics
NPI:1356349906
Name:MARTIN, CATHERINE STROUD (DO)
Entity type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:STROUD
Last Name:MARTIN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 HOLLOW LN
Mailing Address - Street 2:
Mailing Address - City:ONEIDA
Mailing Address - State:TN
Mailing Address - Zip Code:37841-5827
Mailing Address - Country:US
Mailing Address - Phone:423-215-3753
Mailing Address - Fax:423-214-1004
Practice Address - Street 1:VA LEXINGTON HEALTH CARE
Practice Address - Street 2:300 MEDPARK DRIVE
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42503
Practice Address - Country:US
Practice Address - Phone:606-676-0786
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2024-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDO 1096207V00000X
TNDO1096207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3304161Medicaid
KY64713316Medicaid
TN3304161Medicaid
3304169Medicare PIN