MEDICARE: PAUL JOSEPH LENZ M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	35069164	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1427034743
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAUL JOSEPH LENZ M.D.

Provider Business Mailing Address
First Line	:	155 5TH ST NE
Second Line	:
City	:	BARBERTON
State	:	OH
Zip	:	44203-3332
Country	:	US
Telephone Number	:	330-615-3205
Fax Number	:	330-615-3221

Provider Business Practice Location Address
First Line	:	155 5TH ST NE
Second Line	:
City	:	BARBERTON
State	:	OH
Zip	:	44203-3332
Country	:	US
Telephone Number	:	330-615-3205
Fax Number	:	330-615-3221

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/19/2005
Last Update Date	:	09/14/2011

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