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General NPI Number Information
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NPI Number | 1255383469
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Entity Type | Individual
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Provider Name | WADE E LENZ M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/16/2006
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Last Update Date | 06/04/2021
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Provider Practice Location Address
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Address Line | 5600 BRAINERD RD STE A4
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City | CHATTANOOGA
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State | TN
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Zip | 37411-5336
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Country | US
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Telephone | 423-266-4588
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Fax | 423-342-0103
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Provider Business Mailing Address
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Address Line | 1949 GUNBARREL RD STE 206
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City | CHATTANOOGA
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State | TN
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Zip | 37421-7133
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Country | US
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Telephone | 423-495-4345
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Fax | 423-495-4934
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | MD55948
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License Number State | TN
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