Individual
DR. SHAUN G LENCKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 E PRIMROSE ST STE 360, SPRINGFIELD, MO 65807-5293
(417) 269-4037
(417) 269-6139
Mailing address
PO BOX 4046, SPRINGFIELD, MO 65808-4046
(417) 269-5712
(417) 269-7567
Taxonomy
Speciality
Code
Description
License number
State
207VM0101X
Maternal & Fetal Medicine Physician
Primary
2020007993
MO
207VM0101X
Maternal & Fetal Medicine Physician
ME86568
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
202013798
TAX ID
FL
05
—
265903400
—
FL
01
—
5361051
AETNA
FL
01
—
62954
BC/BS
FL
01
—
N290176
HEALTHEASE (MEDICIAD HMO)
FL
Enumeration date
10/13/2005
Last updated
03/25/2020
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