Provider Demographics
NPI:1265836472
Name:LENTZ URGENT CARE & FAMILY MED, INC
Entity type:Organization
Organization Name:LENTZ URGENT CARE & FAMILY MED, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INCORPORATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:LENTZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:912-424-0244
Mailing Address - Street 1:182 SUNSET BLVD
Mailing Address - Street 2:
Mailing Address - City:JESUP
Mailing Address - State:GA
Mailing Address - Zip Code:31545-0401
Mailing Address - Country:US
Mailing Address - Phone:912-385-2102
Mailing Address - Fax:912-385-2180
Practice Address - Street 1:182 SUNSET BLVD
Practice Address - Street 2:
Practice Address - City:JESUP
Practice Address - State:GA
Practice Address - Zip Code:31545-0401
Practice Address - Country:US
Practice Address - Phone:912-385-2102
Practice Address - Fax:912-385-2180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-17
Last Update Date:2014-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty