Healthcare Provider Details

I. General information

NPI: 1306709795
Provider Name (Legal Business Name): LATOYA STRUM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/03/2025
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5338 PIKE LOOP
PIKE ROAD AL
36064-0229
US

IV. Provider business mailing address

5338 PIKE LOOP
PIKE ROAD AL
36064-0229
US

V. Phone/Fax

Practice location:
  • Phone: 334-202-9227
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2022092594
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: