Provider Demographics
NPI:1073757548
Name:LHM CLINIC, P.C. OF SYLACAUGA
Entity Type:Organization
Organization Name:LHM CLINIC, P.C. OF SYLACAUGA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADETOKUNBO
Authorized Official - Middle Name:
Authorized Official - Last Name:LADIPO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-245-9140
Mailing Address - Street 1:303 N MAIN AVE
Mailing Address - Street 2:
Mailing Address - City:SYLACAUGA
Mailing Address - State:AL
Mailing Address - Zip Code:35150-2629
Mailing Address - Country:US
Mailing Address - Phone:256-245-9140
Mailing Address - Fax:256-245-9142
Practice Address - Street 1:303 N MAIN AVE
Practice Address - Street 2:
Practice Address - City:SYLACAUGA
Practice Address - State:AL
Practice Address - Zip Code:35150-2629
Practice Address - Country:US
Practice Address - Phone:256-245-9140
Practice Address - Fax:256-245-9142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-28
Last Update Date:2009-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL23571207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL0515100015Medicare PIN
ALG81388Medicare UPIN