Organization
G REX STROUD JR MD PC
Active
Other names
Stroud Medical
Organization subpart
No
Provider details
NPI number
Authorized official
G REX STROUD MD (OWNER)
(812) 254-4399
Entity
Organization
Contact information
Practice address
201 E MAIN ST, WASHINGTON, IN 47501-2970
(812) 254-4399
(812) 254-4473
Mailing address
PO BOX 3276, EVANSVILLE, IN 47731-3276
(812) 473-0181
(812) 473-5822
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01057059A
IN
261QR1300X
Rural Health Clinic/Center
01057059A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15D2044671
CLIA
IN
05
—
201087090A
—
IN
Enumeration date
08/01/2012
Last updated
01/04/2019
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