Provider Demographics
NPI:1932120441
Name:LENZMEIER, THOMAS CLAUDE (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:CLAUDE
Last Name:LENZMEIER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20100 N 51ST AVE
Mailing Address - Street 2:STE F630
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-5125
Mailing Address - Country:US
Mailing Address - Phone:623-376-8000
Mailing Address - Fax:623-376-8040
Practice Address - Street 1:20100 N 51ST AVE
Practice Address - Street 2:STE F630
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-5125
Practice Address - Country:US
Practice Address - Phone:623-376-8000
Practice Address - Fax:623-376-8040
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2014-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ25528207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ25528OtherMEDICAL LICENSE NUMBER
G92496Medicare UPIN
Z27245Medicare ID - Type Unspecified