Provider Demographics
NPI:1649263625
Name:TROUTT, TERRY LEE (MD)
Entity type:Individual
Prefix:DR
First Name:TERRY
Middle Name:LEE
Last Name:TROUTT
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 1:136 PROFESSIONAL AVE
Mailing Address - Street 2:STE 8
Mailing Address - City:WINCHESTER
Mailing Address - State:KY
Mailing Address - Zip Code:40391-1116
Mailing Address - Country:US
Mailing Address - Phone:859-744-9252
Mailing Address - Fax:859-744-9118
Practice Address - Street 1:136 PROFESSIONAL AVE
Practice Address - Street 2:STE 8
Practice Address - City:WINCHESTER
Practice Address - State:KY
Practice Address - Zip Code:40391-1116
Practice Address - Country:US
Practice Address - Phone:859-744-9252
Practice Address - Fax:859-744-9118
Is Sole Proprietor?:No
Enumeration Date:2005-08-25
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY31418174400000X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000051791OtherANTHEM BCBS
KY64314180Medicaid
KY64314180Medicaid
KYG17020Medicare UPIN