Provider Demographics
NPI:1265819809
Name:LEAN MEDICAL SERVICES, PLLC
Entity Type:Organization
Organization Name:LEAN MEDICAL SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:GILMER
Authorized Official - Middle Name:JESUS
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-567-1493
Mailing Address - Street 1:3299 OVERTON TRL
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA
Mailing Address - State:AL
Mailing Address - Zip Code:35243-4865
Mailing Address - Country:US
Mailing Address - Phone:205-567-1493
Mailing Address - Fax:205-536-6417
Practice Address - Street 1:3299 OVERTON TRL
Practice Address - Street 2:
Practice Address - City:VESTAVIA
Practice Address - State:AL
Practice Address - Zip Code:35243-4865
Practice Address - Country:US
Practice Address - Phone:205-567-1493
Practice Address - Fax:205-536-6417
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-04
Last Update Date:2015-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty