Provider Demographics
NPI:1225476393
Name:LENZ, CRAIG JEROME JR (DO)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:JEROME
Last Name:LENZ
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 N. WILEY AVE
Mailing Address - Street 2:
Mailing Address - City:DONALSONVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:39845-1127
Mailing Address - Country:US
Mailing Address - Phone:229-524-8489
Mailing Address - Fax:229-524-6237
Practice Address - Street 1:900 N. WILEY AVE
Practice Address - Street 2:
Practice Address - City:DONALSONVILLE
Practice Address - State:GA
Practice Address - Zip Code:39845-1127
Practice Address - Country:US
Practice Address - Phone:229-524-8489
Practice Address - Fax:229-524-6237
Is Sole Proprietor?:No
Enumeration Date:2013-06-11
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA78067207V00000X
GA6097207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology