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General NPI Number Information
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NPI Number | 1003449968
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Entity Type | Organization
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Legal Business Name | LENTZ URGENT CARE & FAMILY MED, INC
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Dates
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Enumeration Date | 02/19/2020
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Last Update Date | 08/31/2023
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Provider Practice Location Address
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Address Line | 182 SUNSET BLVD
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City | JESUP
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State | GA
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Zip | 31545-0401
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Country | US
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Telephone | 912-385-2102
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Fax | 912-385-2180
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Provider Business Mailing Address
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Address Line | 182 SUNSET BLVD
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City | JESUP
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State | GA
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Zip | 31545-0401
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Country | US
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Telephone | 912-385-2102
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Fax |
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Authorized Official
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Title or Position | OWNER/DOCTOR
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Name | RANDY LENTZ
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Credential | MD
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Telephone | 912-385-2102
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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