Provider Demographics
NPI:1548605389
Name:ALBERT E. LESTER M.D., P.A.
Entity Type:Organization
Organization Name:ALBERT E. LESTER M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:LESTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:334-262-0331
Mailing Address - Street 1:3091 GASTON AVE STE B
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36105-1541
Mailing Address - Country:US
Mailing Address - Phone:334-262-0331
Mailing Address - Fax:334-262-2993
Practice Address - Street 1:3091 GASTON AVE STE B
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36105-1541
Practice Address - Country:US
Practice Address - Phone:334-262-0331
Practice Address - Fax:334-262-2993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-07
Last Update Date:2013-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL7282207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000003624Medicaid
AL406111978OtherSTATE OF ALABAMA MEDICARE PROVIDER NUMBER
AL03624OtherMEDICARE PROVIDER NUMBER
AL000003624Medicaid