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NPI Code Detail

MEDICARE: DR. WADE E LENZ M.D.

MEDICARE: DR. WADE E 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
1207Q00000XFamily Medicine PhysicianMD55948TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1070114OTHERHEALTH ALLIANCE
2190471OTHERIOWA HEALTH SOLUTIONS
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4IA0194OTHERJOHN DEERE HEALTH
5235474OTHERMIDLANDS CHOICE
642938OTHERIAWELLMARK BC/BS

General Provider Information

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

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