Basic Information
| Provider Information | |||||||||
| NPI: | 1851368757 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LEMAK | ||||||||
| FirstName: | LAWRENCE | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5018 CAHABA RIVER RD | ||||||||
| Address2: | |||||||||
| City: | VESTAVIA | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352432317 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2053975200 | ||||||||
| FaxNumber: | 2053975218 | ||||||||
| Practice Location | |||||||||
| Address1: | 5018 CAHABA RIVER RD | ||||||||
| Address2: | |||||||||
| City: | VESTAVIA | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352432317 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2053975200 | ||||||||
| FaxNumber: | 2053975220 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/01/2006 | ||||||||
| LastUpdateDate: | 09/23/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/23/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 5433 | AL | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | 200011540 | 01 | AL | RAILROAD MEDICARE | OTHER | 510-09831 | 01 | BLUE CROSS BLUE SHIELD | OTHER | 0310040001 | 01 | AL | CIGNA GOVERNMENT SERVICES | OTHER | 051556187 | 05 | AL | MEDICAID | 51521094 | 01 | AL | BLUE CROSS | OTHER |