Healthcare Provider Details

I. General information

NPI: 1356349906
Provider Name (Legal Business Name): CATHERINE STROUD MARTIN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2005
Last Update Date: 12/27/2024
Certification Date: 12/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

VA LEXINGTON HEALTH CARE 300 MEDPARK DRIVE
SOMERSET KY
42503
US

IV. Provider business mailing address

103 HOLLOW LN
ONEIDA TN
37841-5827
US

V. Phone/Fax

Practice location:
  • Phone: 606-676-0786
  • Fax:
Mailing address:
  • Phone: 423-215-3753
  • Fax: 423-214-1004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberDO 1096
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDO1096
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: