MEDICARE: JEAN B LENK 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
1	207R00000X	Internal Medicine Physician	35058732	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770570335
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEAN B LENK M.D.

Provider Business Mailing Address
First Line	:	PO BOX 378
Second Line	:
City	:	SANDUSKY
State	:	OH
Zip	:	44871-0378
Country	:	US
Telephone Number	:	419-626-6161
Fax Number	:	419-502-3511

Provider Business Practice Location Address
First Line	:	36100 EUCLID AVE
Second Line	:	SUITE 430
City	:	WILLOUGHBY
State	:	OH
Zip	:	44094-4456
Country	:	US
Telephone Number	:	440-946-4070
Fax Number	:	440-946-4071

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/29/2005
Last Update Date	:	09/02/2020

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Directions to “ JEAN B LENK M.D.” Practice Location

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