Provider Demographics
NPI:1326149907
Name:LENNINGTON, WAYNE J (MD)
Entity Type:Individual
Prefix:
First Name:WAYNE
Middle Name:J
Last Name:LENNINGTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:5301 VIRGINIA WAY
Mailing Address - Street 2:STE 300
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-7541
Mailing Address - Country:US
Mailing Address - Phone:615-221-4474
Mailing Address - Fax:615-234-3774
Practice Address - Street 1:5301 VIRGINIA WAY
Practice Address - Street 2:STE 300
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-7541
Practice Address - Country:US
Practice Address - Phone:615-221-4474
Practice Address - Fax:615-234-3774
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TN19614207ZP0102X
KY33244207ZP0102X
GA037267207ZP0102X
IL207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN119359OtherUNISON TENNCARE
GA10057951OtherAMERIGROUP GA MEDICAIDCMO
TN3045383OtherBLUE CROSS
GA335766OtherWELLCARE GA MEDICAID CMO
TN3066654Medicaid
NC5902744Medicaid
KY64926959Medicaid
TN000000008828OtherTLC TENNCARE
KY64926959Medicaid
TN000000008828OtherTLC TENNCARE
GA335766OtherWELLCARE GA MEDICAID CMO
ILL73308Medicare ID - Type Unspecified