MEDICARE: DR. TERRY LEE TROUTT MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	31418	KY
2	208100000X	Physical Medicine & Rehabilitation Physician	31418	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000051791	OTHER	KY	ANTHEM BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1649263625
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TERRY LEE TROUTT MD

Provider Business Mailing Address
First Line	:	136 PROFESSIONAL AVE
Second Line	:	STE 8
City	:	WINCHESTER
State	:	KY
Zip	:	40391-1116
Country	:	US
Telephone Number	:	859-744-9252
Fax Number	:	859-744-9118

Provider Business Practice Location Address
First Line	:	136 PROFESSIONAL AVE
Second Line	:	STE 8
City	:	WINCHESTER
State	:	KY
Zip	:	40391-1116
Country	:	US
Telephone Number	:	859-744-9252
Fax Number	:	859-744-9118

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/25/2005
Last Update Date	:	06/27/2023

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