Provider Demographics
NPI:1891859880
Name:ADLER, LESTER ALLEN (MD)
Entity Type:Individual
Prefix:
First Name:LESTER
Middle Name:ALLEN
Last Name:ADLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 SUNSET DR
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:SEDONA
Mailing Address - State:AZ
Mailing Address - Zip Code:86336-5406
Mailing Address - Country:US
Mailing Address - Phone:928-282-2520
Mailing Address - Fax:928-282-2895
Practice Address - Street 1:40 SOLDIERS PASS RD
Practice Address - Street 2:SUITE 11-15
Practice Address - City:SEDONA
Practice Address - State:AZ
Practice Address - Zip Code:86336-4780
Practice Address - Country:US
Practice Address - Phone:928-282-2520
Practice Address - Fax:928-282-2895
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2013-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ17531207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ0872130OtherBLUE CROSS BLUE SHIELD
AZ137806Medicaid
AZ62102Medicare ID - Type Unspecified
AZA37480Medicare UPIN