Healthcare Provider Details

I. General information

NPI: 1003449968
Provider Name (Legal Business Name): LENTZ URGENT CARE & FAMILY MED, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2020
Last Update Date: 08/31/2023
Certification Date: 08/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

182 SUNSET BLVD
JESUP GA
31545-0401
US

IV. Provider business mailing address

182 SUNSET BLVD
JESUP GA
31545-0401
US

V. Phone/Fax

Practice location:
  • Phone: 912-385-2102
  • Fax: 912-385-2180
Mailing address:
  • Phone: 912-385-2102
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: RANDY LENTZ
Title or Position: OWNER/DOCTOR
Credential: MD
Phone: 912-385-2102