Provider Demographics
NPI:1871568063
Name:LEMASTER, KENNETH F (MD)
Entity type:Individual
Prefix:
First Name:KENNETH
Middle Name:F
Last Name:LEMASTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:323 N MONTGOMERY AVE
Mailing Address - Street 2:
Mailing Address - City:SHEFFIELD
Mailing Address - State:AL
Mailing Address - Zip Code:35660-2708
Mailing Address - Country:US
Mailing Address - Phone:256-381-6673
Mailing Address - Fax:256-381-8091
Practice Address - Street 1:323 N MONTGOMERY AVE
Practice Address - Street 2:
Practice Address - City:SHEFFIELD
Practice Address - State:AL
Practice Address - Zip Code:35660-2708
Practice Address - Country:US
Practice Address - Phone:256-381-6673
Practice Address - Fax:256-381-8091
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-21
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL11543174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALC71237Medicare UPIN