Provider Demographics
NPI:1750788998
Name:DR. THOMAS P LENNS, LLC
Entity type:Organization
Organization Name:DR. THOMAS P LENNS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:P
Authorized Official - Last Name:LENNS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:843-681-5305
Mailing Address - Street 1:89 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HILTON HEAD
Mailing Address - State:SC
Mailing Address - Zip Code:29926-6613
Mailing Address - Country:US
Mailing Address - Phone:843-681-5305
Mailing Address - Fax:843-689-5210
Practice Address - Street 1:89 MAIN ST
Practice Address - Street 2:
Practice Address - City:HILTON HEAD
Practice Address - State:SC
Practice Address - Zip Code:29926-6613
Practice Address - Country:US
Practice Address - Phone:843-681-5305
Practice Address - Fax:843-689-5210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-03
Last Update Date:2015-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC14657208D00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty