Provider Demographics
NPI:1801803994
Name:STROUD, MALEAH E (OD)
Entity type:Individual
Prefix:DR
First Name:MALEAH
Middle Name:E
Last Name:STROUD
Suffix:
Gender:
Credentials:OD
Other - Prefix:DR
Other - First Name:MALEAH
Other - Middle Name:E
Other - Last Name:FARNAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:302 W 14TH ST STE 100A
Mailing Address - Street 2:
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47130-3751
Mailing Address - Country:US
Mailing Address - Phone:812-284-0660
Mailing Address - Fax:
Practice Address - Street 1:849 PACER DR NW
Practice Address - Street 2:
Practice Address - City:CORYDON
Practice Address - State:IN
Practice Address - Zip Code:47112-2145
Practice Address - Country:US
Practice Address - Phone:812-738-2278
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1642DT152W00000X
IN18003355A152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY77001626Medicaid
KY77001626Medicare Oscar/Certification
KY5375220003Medicare NSC
KY0959009Medicare PIN
5375220004Medicare NSC