Provider Demographics
NPI:1235676123
Name:LEMAK SPORTS MEDICINE, LLC
Entity Type:Organization
Organization Name:LEMAK SPORTS MEDICINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:LEMAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-329-7501
Mailing Address - Street 1:1286 OAK GROVE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-6929
Mailing Address - Country:US
Mailing Address - Phone:205-329-7519
Mailing Address - Fax:
Practice Address - Street 1:5018 CAHABA RIVER RD
Practice Address - Street 2:
Practice Address - City:VESTAVIA
Practice Address - State:AL
Practice Address - Zip Code:35243-2317
Practice Address - Country:US
Practice Address - Phone:205-397-5200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-30
Last Update Date:2017-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty