Individual
TED A LENNARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3801 S NATIONAL AVE, WEST TOWER, SUTIE 900, SPRINGFIELD, MO 65807-5210
(417) 885-3888
(417) 881-7638
Mailing address
PO BOX 9434, SPRINGFIELD, MO 65801-9434
(417) 885-3888
(417) 881-7638
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
0000032129
TN
208100000X
Physical Medicine & Rehabilitation Physician
18119
LA
208100000X
Physical Medicine & Rehabilitation Physician
R3879
AR
208100000X
Physical Medicine & Rehabilitation Physician
Primary
R9N55
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0201383
DEPARTMENT OF LABOR WA
WA
01
—
152849
BLUE CROSS/CHOICE
MO
05
—
168253001
—
AR
01
—
1842
COX HEALTH PLAN UPI
MO
05
—
202972212
—
MO
01
—
4188130001
CIGNA MEDICARE
MO
01
—
6354796002
CIGNA HEALTHCARE
MO
01
—
E35997
USPS (W/C)
MO
Enumeration date
05/22/2006
Last updated
08/21/2015
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