Provider Demographics
NPI:1356818090
Name:MEDPLEX, INC.
Entity Type:Organization
Organization Name:MEDPLEX, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:LAZENBY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-731-9090
Mailing Address - Street 1:2124 4TH AVE S
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35233-2204
Mailing Address - Country:US
Mailing Address - Phone:205-731-9090
Mailing Address - Fax:205-731-0760
Practice Address - Street 1:2124 4TH AVE S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-2204
Practice Address - Country:US
Practice Address - Phone:205-731-9090
Practice Address - Fax:205-731-0760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-31
Last Update Date:2018-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction MedicineGroup - Single Specialty