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General NPI Number Information
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NPI Number | 1467637611
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Entity Type | Organization
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Legal Business Name | LENTZ PEDIATRICS, PLC
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Dates
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Enumeration Date | 01/07/2008
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Last Update Date | 01/13/2025
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Provider Practice Location Address
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Address Line | 10777 HIGHWAY 412 W
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City | LEXINGTON
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State | TN
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Zip | 38351-6283
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Country | US
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Telephone | 731-968-5558
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Fax | 731-968-5567
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Provider Business Mailing Address
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Address Line | 19 SECURITY DR
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City | JACKSON
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State | TN
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Zip | 38305-3626
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Country | US
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Telephone | 731-664-9040
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Fax | 731-664-9041
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Authorized Official
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Title or Position | PHYSICIAN
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Name | MR. JONATHAN D LENTZ
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Credential | MD
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Telephone | 731-664-9040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 31704
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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