Individual
MILTON A LENNICX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1900 FAIRVIEW AVE, DOTHAN, AL 36301-3008
(334) 793-9511
(334) 794-0721
Mailing address
2015 ALEXANDER DR, DOTHAN, AL 36301-3003
(334) 671-1696
(334) 794-0721
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
06616
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000003612
—
AL
05
—
000189175A
—
GA
05
—
009941384
—
AL
05
—
009996115
—
AL
05
—
009996135
—
AL
05
—
009996175
—
AL
05
—
042857400
—
FL
Enumeration date
11/28/2005
Last updated
01/15/2010
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