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General NPI Number Information
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NPI Number | 1285766121
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Entity Type | Individual
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Provider Name | MICHELLE LYNNNE STRONG M.D., PH.D.
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Gender | Female
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Dates
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Enumeration Date | 03/09/2007
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Last Update Date | 03/24/2021
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Provider Practice Location Address
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Address Line | 800 E DAWSON ST
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City | TYLER
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State | TX
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Zip | 75701-2036
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Country | US
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Telephone | 903-606-5864
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Fax | 903-606-1930
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Provider Business Mailing Address
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Address Line | 3340 E GOLDSTONE DR
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City | MERIDIAN
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State | ID
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Zip | 83642-1026
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Country | US
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Telephone | 208-367-5170
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | MD60080540
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | M-12449
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License Number State | ID
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Taxonomy #3
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Taxonomy Code | 2086S0127X
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Taxonomy Name | Trauma Surgery Physician
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License Number | MD60080540
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License Number State | WA
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Taxonomy #4
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Taxonomy Code | 2086S0127X
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Taxonomy Name | Trauma Surgery Physician
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License Number | Q6576
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License Number State | TX
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Taxonomy #5
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | Q6576
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License Number State | TX
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