Basic Information
| Provider Information | |||||||||
| NPI: | 1518252584 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STROUP | ||||||||
| FirstName: | KIMBERLY | ||||||||
| MiddleName: | W | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | O.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4247 CANDLE BROOK LN | ||||||||
| Address2: | |||||||||
| City: | BESSEMER | ||||||||
| State: | AL | ||||||||
| PostalCode: | 350228342 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 911 HARGROVE RD E | ||||||||
| Address2: | |||||||||
| City: | TUSCALOOSA | ||||||||
| State: | AL | ||||||||
| PostalCode: | 354051602 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2055077810 | ||||||||
| FaxNumber: | 2055547399 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/17/2011 | ||||||||
| LastUpdateDate: | 09/24/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | S-C66-TA-892 | AL | Y | Eye and Vision Services Providers | Optometrist |
No ID Information.