Basic Information
| Provider Information | |||||||||
| NPI: | 1346229515 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STROUP | ||||||||
| FirstName: | KEVIN | ||||||||
| MiddleName: | H | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 200 W CHURCH ST | ||||||||
| Address2: | |||||||||
| City: | LEXINGTON | ||||||||
| State: | TN | ||||||||
| PostalCode: | 383512038 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7319683646 | ||||||||
| FaxNumber: | 7319681870 | ||||||||
| Practice Location | |||||||||
| Address1: | 200 W CHURCH ST | ||||||||
| Address2: | |||||||||
| City: | LEXINGTON | ||||||||
| State: | TN | ||||||||
| PostalCode: | 383512038 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7319683646 | ||||||||
| FaxNumber: | 7319681870 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/16/2006 | ||||||||
| LastUpdateDate: | 06/28/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/28/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 23810 | TN | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | TN0102 | 01 | TN | AMERICHOICE | OTHER | 4117685 | 01 | TN | BCBS | OTHER | 184234 | 01 | TN | UNISON | OTHER | 184234 | 01 | TN | BETTER HEALTH PLAN OF TN | OTHER | 36935 | 01 | TN | TLC | OTHER | 610916101 | 01 | TN | US DEPT. OF LABOR | OTHER | 3835292 | 05 | TN | MEDICAID | 484925 | 01 | TN | MULTIPLAN | OTHER | 8167952 | 01 | TN | CIGNA | OTHER |