Provider Demographics
NPI:1740376128
Name:LESTER, ALBERT EUGENE (MD)
Entity type:Individual
Prefix:
First Name:ALBERT
Middle Name:EUGENE
Last Name:LESTER
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 1:3091 GASTON AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36105
Mailing Address - Country:US
Mailing Address - Phone:334-262-0331
Mailing Address - Fax:334-262-2993
Practice Address - Street 1:3091 GASTON AVE
Practice Address - Street 2:SUITE B
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36105
Practice Address - Country:US
Practice Address - Phone:334-262-0331
Practice Address - Fax:334-262-2993
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2013-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL7282207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000003624Medicaid
AL03624OtherMEDICARE PROVIDER NUMBER
AL406111978OtherSTATE OF ALABAMA MEDICARE PROVIDER NUMBER
AL000003624Medicaid